Esophagoduodenostomy and loop esophagojejunostomy with or without enteroenterostomy may not be the optimal reconstructive procedures after total gastrectomy because of esophagitis and dumping. More effective esophagointestinal anastomoses have been described [1,3,4,8,9,12]. We have had good success using a Roux-en-Y esophagojejunostomy with and without a jejunal pouch after total gastrectomy for the Zollinger-Ellison syndrome and agree that a jejunal pouch associated with Roux-en-Y esophagojejunostomy as described by Hunt and Lawrence is an excellent reconstructive procedure [1,13]. Several reports using this type of procedure have emphasized the absence of alkaline reflux esophagitis and the ability of their patients to maintain ideal weight [1,2,8].