{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T23:25:09Z","timestamp":1790724309338,"version":"4.1.0"},"reference-count":34,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[1991,3,1]],"date-time":"1991-03-01T00:00:00Z","timestamp":667785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[1991,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:bold>Three surgical complications of Chagas' disease\u2014megaesophagus, achalasia of the pylorus, and cholelithiasis\u2014were evaluated within the framework of the experience acquired in the management of 840 cases of megaesophagus\u2014722\u00a0in the nonadvanced stage of the disease and 118 with advanced disease (dolichomegaesophagus)<\/jats:bold>.<\/jats:p><jats:p><jats:bold>In the group of the 722 patients with nonadvanced disease, achalasia of the pylorus was present in 140 (19.4%), and in the total of 840 patients, uncomplicated cholelithiasis without chagasic involvement of the gallbladder and\/or papilla was observed in 58 (6.9%)<\/jats:bold>.<\/jats:p><jats:p><jats:bold>The 722 subjects with nonadvanced megaesophagus were submitted to wide esophagocardiomyectomy performed at the level of the anterior esophagogastric junction, combined with an antireflux valvuloplasty procedure. We recorded no mortality, and 95% excellent and good results in long\u2010term follow\u2010up. On the other hand, dolichomegaesophagus required esophageal resection with reconstruction by means of an esophagogastroplasty placed in the esophageal bed. The mortality rate was 4.2% (5\/118); the main postoperative complications were pleural effusion (22%) and fistulas of the esophagogastric anastomosis (8.4%). Postoperatively, the patients adapted well to their new anatomy and gained weight. Achalasia of the pylorus was confirmed by delayed gastric emptying time. This entity was managed by concomitant antropyloromyectomy without mortality. Cholelithiasis was managed by cholecystectomy and radiologic exploration of the bile ducts<\/jats:bold>.<\/jats:p>","DOI":"10.1007\/bf01659053","type":"journal-article","created":{"date-parts":[[2005,5,8]],"date-time":"2005-05-08T12:56:40Z","timestamp":1115557000000},"page":"198-204","source":"Crossref","is-referenced-by-count":40,"title":["Surgical complications of Chagas' disease: Megaesophagus, achalasia of the pylorus, and cholelithiasis"],"prefix":"10.1002","volume":"15","author":[{"given":"Henrique Walter","family":"Pinotti","sequence":"first","affiliation":[{"name":"Division of Digestive Surgery Department of Gastroenterology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valter Nilton","family":"Felix","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Department of Gastroenterology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Zilberstein","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Department of Gastroenterology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivan","family":"Cecconello","sequence":"additional","affiliation":[{"name":"Division of Digestive Surgery Department of Gastroenterology Hospital das Cl\u00ednicas University of S\u00e3o Paulo Medical School S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[1991,3]]},"reference":[{"key":"e_1_2_1_2_1","first-page":"36","article-title":"Trypanosoma cruzi: Immunological consequences of parasite modification of host cells","volume":"40","author":"Ribero dos Santos R.","year":"1980","journal-title":"Clin. 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