Indications for Roux-en-Y reconstruction after a distal gastrectomy are: (a) When the primary lesion has directly invaded the duodenum or head of the pancreas, the Billroth I operation is likely to result in local recurrence near the anastomosis; (b) in addition, the Billroth I operation is not indicated after a subtotal gastrectomy due to an. . Typically, it is between stomach and small bowel that is distal (or further down the gastrointestinal tract) from the cut end
The complications seen with jejunostomy can be mechanical, infectious, gastrointestinal, or metabolic. The rate of technical complications of the Witzel longitudinal technique is 2.1%, for the transverse Witzel up to 6.6%, for the Roux-en-Y 21%, for open gastrojejunostomy from 2%, and for the needle catheter technique from 1.5% with 0.14%. Background/aims: After a distal resection of the stomach, the continuity of the gastrointestinal tract can be restored by either a gastroduodenal anastomosis (Billroth I), a gastrojejunal anastomosis (Billroth II) or a Roux-en-Y gastrojejunostomy. There is still no consensus on the reconstruction technique of choice. The aim of this report was to assess the value of Roux-en-Y (RY. Roux-en-Y gastrojejunostomy has become a popular choice owing to the ability to use a smaller gastric remnant with better bile reflux control and less postoperative dumping syndrome observed. For reconstruction after total gastrectomy, Roux-en-Y esophagojejunostomy, jejunal interposition, and pouch reconstruction are all available options The Roux stasis syndrome was much more common in the era of gastrectomy (including vagotomy) for duodenal ulcer and gastric cancer and was a well-recognized, though poorly understood, postgastrectomy syndrome that followed a Roux-en-Y type of reconstruction
, operative techniques, and postoperative outcome in patients with previous Roux-en-Y gastric bypass Conversion from sleeve gastrectomy to Roux-en-Y gastric bypass--indications and outcome Obes Surg. 2010 Jul;20(7) :835-40. Postoperative complications were observed in only one patient as leakage at the gastrojejunostomy was successfully treated by temporary stent placement. Roux-en-Y / methods Read chapter 26 of Atlas of Minimally Invasive Surgical Operations online now, exclusively on AccessSurgery. AccessSurgery is a subscription-based resource from McGraw Hill that features trusted medical content from the best minds in medicine INDICATIONS FOR PROCEDURE: The patient is a 73-year-old female, who came to the hospital with jaundice, abdominal pain, and nausea. approximately at 15-20 cm from the gastrojejunostomy to create the Roux-en-Y. The distal blind loop was brought up to create the cholecystojejunostomy. We opened the gallbladder at the fundus since the patient. INTRODUCTION. Laparoscopic Roux-en-Y gastric bypass (LRYGB), as a bariatric procedure, was first described by Alan Wittgrove in 1994 .Over the ensuing decades, the technique of LRYGB as well as perioperative care of patients have been gradually improved and refined .Consequently, the mortality rate associated with the RYGB has decreased from 2.6 percent at the turn of the century  to 0.
Roux-en-Y gastrojejunostomy is a common method of reconstruction after subtotal gastrectomy. Maintaining myoneural continuity has been proposed to decrease the incidence of Roux stasis syndrome, with an uncut Roux-en-Y reconstruction. The aim of our study was to compare the clinical results in patients who have undergone uncut Roux-en-Y. Roux-en-Y Gastric Bypass This procedure, often called gastric bypass, was developed in 1967. The operation creates a small upper-stomach pouch (less than one ounce) that limits food eaten and makes you feel full and satisfied with only a small amount. Also, not all food is digested because part of the small intestine is bypassed This video is available for instant download licensing here: https://www.alilamedicalmedia.com/-/galleries/narrated-videos-by-topics/bariatric-surgeries/-/me.. Roux-en-Y gastrojejunostomy is a common method of reconstruction after subtotal gastrectomy. Maintaining myoneural continuity has been proposed to decrease the incidence of Roux stasis syndrome, with an uncut Roux-en-Y reconstruction. Indications for the operation included gastroparesis in four, gastric adenocarcinoma in three, bile. Background Due to excellent weight loss success in the short-time follow-up, sleeve gastrectomy (SG) has gained popularity as sole and definitive bariatric procedure. In the long-term follow-up, weight loss failure and intractable severe reflux can necessitate further surgical intervention. Methods A retrospective analysis of laparoscopic conversions from SG to Roux-en-Y gastric bypass (RYGB.
Background: Roux-en-Y Hepaticojejunostomy (RYHJ) is the most common form of reconstruction of the biliary pathway. It is a time honoured, durable, less resource intensive and a deﬁ nitive procedure Laparoscopic Roux-en-Y gastric bypass (RYGB) is proven to be a safe and effective treatment of obesity and related co-morbidities. However, there is a small group of patients who are unable to tolerate postoperative complications and ultimately undergo reversal procedures. This study demonstrates indications and postoperative outcomes in 8 patients following RYGB reversal In the latter two patients, indications for operation were alkaline reflux gastritis after cholecystectomy and gastric atony after a Nissen fundoplication. The indications for the original Roux-Y gastrojejunostomy were similar in Table 1. Characteristics of Study Participants Roux patients Characteristic Healthy Asymp
In this live educational video, Dr. Michel Vix demonstrates a stepwise laparoscopic Roux-en-Y gastric bypass procedure in a 39-year-old female patient with a BMI of 38. After stapled creation of the gastric pouch and splitting of the greater omentum, a stapled (antecolic/antegastric) gastrojejunostomy and a jejunojejunostomy are performed The aim of this study was to compare a new type of uncut Roux-en-Y gastrojejunostomy with the conventional Roux-en-Y gastrojejunostomy after subtotal gastrectomy. METHODS: 51 patients (31 men and 20 women) had the conventional Roux-en-Y reconstruction and 54 patients (38 men and 16 women) had the new type of uncut Roux-en-Y reconstruction Results: 17 patients (10 women, 7 men), median age 54 years (range 38-87), with prior Roux-en-Y gastrojejunostomy underwent ERCP at our center between 3/90 and 10/96. Indications for ERCP were pancreatitis (3), cholestasis with known or suspected biliary pathology (8) and right subcostal pain with abnormal liver function tests (6) In conclusion, Roux en Y gastrojejunostomy following the SL is a known treatment for a chronic leak. In this study, we aimed to show that early use of Roux limb after the failure of initial conservative therapy is a safe and feasible treatment even in patients with SIRS criteria Roux en Y gastrojejunostomy Gastric bypass (Roux-en-Y) - Mayo Clini . Overview Gastric bypass, also called Roux-en-Y (roo-en-wy) gastric bypass, is a type of weight-loss surgery that involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine Read chapter 33 of Zollinger's Atlas of Surgical Operations, 10e online now, exclusively on.
Gastrotomy with anvil dunk: a novel technique for gastrojejunostomy in the patient undergoing laparoscopic Roux-en-Y gastric bypass Diego Camacho The National Institutes of Health (NIH) consensus conference in 1991 determined that bariatric surgery is the most effective method for achieving durable longterm weight loss for morbidly obese. Roux-en-Y gastric bypass surgery. In many centres, laparoscopic Roux-en-Y gastric bypass has become the most common bariatric procedure for morbid obesity . In this operation, the stomach is stapled or divided to form a small pouch (typically <30 mL in volume), which empties into a Roux limb of the jejunum of varying length (typically 75-150 cm) For a Roux-en-Y gastrojejunostomy, the jejunum is divided several centimeters distal to the ligament of Treitz. The proximal portion of the distal jejunal segment is anastomosed to the stomach Conversion to a Roux-en-Y gastrojejunostomy as a remedial operation has gained favor relatively recently. With this operation, favorable outcomes have been reported in 85-90% of patients
Roux-en-Y hepaticojejunostomy (RYHJ) is currently considered as the definitive treatment for iatrogenic bile duct injuries . roux-en-y醫學 roux-en-y gastrojejunostomy. The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients). The. Roux-en-Y Gastric Bypass. This procedure, often called gastric bypass, was developed in 1967. The operation creates a small upper-stomach pouch (less than one ounce) that limits food eaten and makes you feel full and satisfied with only a small amount. Also, not all food is digested because part of the small intestine is bypassed
The Roux-en-Y laparoscopic gastric bypass, first performed in 1993, is regarded as one of the most difficult procedures to perform by limited access techniques, but use of this method has greatly popularized the operation due to associated benefits such as a shortened hospital stay, reduced discomfort, shorter recovery time, less scarring, and. 17. Daellenbach L, Suter M. Jejuno-jejunal intussusception after Roux-en-Y gastric bypass: a review. Obes Surg. 2011; 21(2): 253-263. 18. Marr B, Yenumula P. Roux limb volvulus in laparoscopic Roux-en-Y gastric bypass due to Roux limb stabilization suture: case series. Obes Surg. 2012;22(1):4-7. 19 Schematic diagram of uncut Roux-en-y anastomosis (URYA). URYA includes an end-to-side gastrojejunostomy which was constructed approximately 20 cm distal to Treitz ligament and a Braun enteroenterostomy which was performed by joining the afferent to efferent limb about 10 and 35 cm away from gastrointestinal anastomosis, respectively, and then the afferent limb was occluded 3 cm away from. Objective . To evaluate Roux-en-Y and Billroth II reconstruction following pancreaticoduodenectomy (PD). Methods . PubMed, Embase, the Cochrane Library, and the Web of Science were searched to identify randomized controlled trials (RCTs) and controlled clinical trials that compared Roux-en-Y and Billroth II reconstruction following PD up to December 2019 A critical evaluation is made of 131 patients submitted to choledocho or hepaticojejunostomy. The main indications for hepaticojejunostomy were iatrogenic strictures of CBD (60 patients), and choledocholithiasis with markedly dilated duct (41 patients). The overall mortality rate was 4% representing principally renal hepatic failure, bile peritonitis and bleeding
Our initial experience with the Roux-en-Y feeding jejunostomy (Maydl's procedure) is encouraging. This technique appears to be a safe and reliable alternative to conventional jejunostomy techniques. 17, 18 Our current opinion is that the indications for G-J tube placement are few. Use of G-J tubes should be confined to children requiring short. Modified Roux en Y hepaticojejunostomy to permit transgastric endoscopic access Acta Cirúrgica Brasileira - Vol. 29 (supl. 3) 2014 - 15 Introduction There are several indications for performing Roux-en-Y hepaticojejunostomy such as, bile duct injury, malignant strictures, benign strictures, multiple gallstones and liver. Purpose . Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is a frequently performed bariatric procedure, there is still no consensus on its technical implementation. Methods . 211 patients treated with LRYGB in a single institution between March 2011 and October 2016 were analyzed retrospectively. A subgroup analysis for the linear (LSA) versus circular stapler technique (CSA) for.
ORLANDO -- Five years following surgery, Roux-en-Y gastric bypass patients had greater weight loss versus sleeve gastrectomy patients, researchers reported here. In a retrospective analysis. Roux-en-Y procedure for alkaline gastritis or esopha gitis, or both (14). The Roux-en-Y operation consists of a gastrojejunostomy using a Roux-en-Y limb. In this procedure (Figure 1) the afferent limb of the duodenum is closed, the orad portion of the jejunum is anastomosed to the remaining gastric pouch, an Patients after Roux-en-Y gastrojejunostomy frequently complain of upper abdominal pain, fullness, nausea and vomiting. This study was performed to clarify the relationship of this Roux-en-Y syndrome to transit disorders in the gastric remnant and Roux limb, and to vagal status. Using a questionnaire, 35 of 66 patients operated on between 1976.
Introduction: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is a common, well-established procedure, but no con-sensus regarding selection of the gastrojejunostomy (GJ) technique has been reached, and standardization of this precise technique is far from being achieved In Korea, the main reconstruction method after distal gastrectomy for gastric cancer surgery is gastroduodenostomy [Billroth I reconstruction (BI)]. When BI is difficult to perform because of tumor location or resection extent, gastrojejunostomy [Billroth II reconstruction (BII)] or Roux-en-Y gastrojejunostomy (RY) is performed Roux-en-Y Hepatico-Jejunostomy listed as R-Y HJ. Roux-en-Y Hepatico-Jejunostomy - How is Roux-en-Y Hepatico-Jejunostomy abbreviated? Major indications for hepatico-jejunostomy are benign or iatrogenic strictures and injuries of biliary system.19,20 The appropriate treatment of major bile duct Roux-en-Y gastrojejunostomy; Roux-en-Y. Obesity is a growing problem in the USA and known risk factor for development of pancreatic malignancy [1,2,3].The Roux-en-Y gastric bypass (RYGB) has proven to be an effective, long-term solution for obesity and its associated morbidities [4,5,6].RYGB addresses the problem of obesity in two ways: a restrictive component involving the creation of a gastric pouch with alimentary limb, and a. This chapter lists the indications, essential steps, common technical variations, and complications of the procedure. A detailed operative note dictation template is included. Keywords Laparoscopic partial gastrectomy Roux-en-Y Gastrojejunostomy.
We present an esophagogastric disconnection and Roux-en-Y gastrojejunostomy as the fourth antireflux procedure in an obese patient with recurrent severe GERD despite high-dose PPI therapy. After previous Nissen fundoplications and a redo procedure with a partial posterior fundoplication, the patient now presented with an intrathoracic migration. partie de ses indications le court-circuit gastrojéjunal de Roux-en-Y, communément appelé bypass gastrique en Y (BPGY). Il est donc réalisé une évaluation de l'efficacité et de la sécurité du BPGO dans la prise en charge chez l'adulte de l'obésité massive (IMC ≥ 40 kg/m2) ou sévèr Eighty-eight percent of patients were female. Roux-en-Y gastric bypass occurred on average 142.43 ±62.33 months prior to suture removal. P rimary indications for endoscopy were evaluation of gastric pouch and gastrojejunal anastomosis for weight regain (37.10%) and abdominal pain (30.65%). Overall, technical success of the se nove Roux-en-Y gastrojejunostomy는 Billroth II와 동일한 상황에서 사용할 수 있지만 십이지장 또는 공장의 연속성을 유지하지는 않습니다. Roux-en-Y gastrojejunostomy는 잔존하는 위를 공장의 isoperistaltic roux limb과 문합합니다
Roux-en-Y gastrojejunostomy는 Billroth II와 동일한 상황에서 사용할 수 있지만 십이지장 또는 공장의 연속성을 유지하지는 않습니다. Roux-en-Y gastrojejunostomy는 잔존하는 위를 공장의 isoperistaltic roux limb과 문합합니다. Proximal jejunum은 end-to-side 방식으로 distal roux limb에. Although gastrojejunal anastomotic strictures are one of the most common complications with laparoscopic Roux-en-Y gastric bypass (, 30), they are often diagnosed and treated at endoscopy. A thorough examination also evaluates for degraded pouch restriction, including a patulous gastrojejunal anastomosis or gastrogastric fistula, as a late. Roux-en-Y gastrojejunostomy , suprapapillary Roux-en-Y duodenojejunostomy (so-called duodenal switch operation) or interposition of a jejunal segment between stomach and duodenum . To avoid stomal ulcerations, the classically performed Roux-en-Y gastrojejunostomy requires an additional antrectomy and vagotomy to reduce gastric acid secretion Patients after Roux-en-Y gastrojejunostomy frequently complain of upper abdominal pain, fullness, nausea and vomiting. This study was performed to clarify the relationship of this Roux-en-Y syndrome. The Roux-en-Y syndrome has been proposed as a motility disorder based on the jejunal limb causing abdominal pain, gastric stasis and vomiting. The ectopic pace-setter potential has been described after Roux-en-Y gastrectomies . However, this syndrome does not appear in patients in whom partial gastrectomy is performed without vagotomy
Background: The purpose of this study is to evaluate our experience with the laparoscopic gastric bypass. The technique, weight loss data, and complications are described. Methods: 1,500 consecutiv.. Roux-en-Y Gastric Bypass Diet and Nutrition Guidelines. email to a friend printer-friendly version. by Sharon George, MS, RD, CDN. Welcome to the wonderful, amazing world of weight loss surgery! This is a very exciting time for you. You have spent the better part of your life between diets and have made the courageous decision to take back. Roux-en-Y Gastric Bypass Surgery. The most common bariatric surgery procedure performed in the United States, Roux-en-Y gastric bypass (RYGB) combines a restrictive and malabsorptive procedures. A small (15-30 cc) gastric pouch is created to restrict food intake and a Roux-en-Y gastrojejunostomy provides the mild malabsorptive component The aim of the present meta‐analysis was to evaluate the effect of Billroth‐II(B‐II) versus Roux‐en‐Y (R‐Y) reconstruction for gastrojejunostomy on DGE after PD. Methods. A systematic literature search was performed using the electronic database MEDLINE (via PubMed and OVID), EMBASE and Cochrane Central Register of Controlled Trials. receive Roux-en-Y gastrojejunostomy suffer from the Roux stasis syndrome ; this reportedly occurs in ap-proximately 30% of patients who undergo a Roux-en-Y gastrojejunostomy after distal gastrectomy . This syndrome consists of nausea, vomiting, abdominal dis-comfort, and bloating after meals. In 1988, va
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y-500 patients: technique and results, with 3-60 month follow-up. Obes Surg 2000;10:233-9. Wittgrove AC, Endres JE, Davis M, et al. Perioperative complications in a single surgeon's experience with 1,000 consecutive laparoscopic Roux-en-Y gastric bypass operations for morbid obesity Esophagocardioplasty, vagotomy-antrectomy and Roux-en-Y gastrojejunostomy: indication in cases with severe esophageal motor disfunction. Dis Esophagus. 2017; 11(1):58-61 (ISSN: 1442-2050
Intussusception is a rare complication following gastric surgery and is estimated to occur in 0.1% of patients. The authors describe a case of retrograde intussusception after Roux-en-Y gastrojejunostomy that was initially diagnosed as pancreatitis because the classic symptoms of intussusception were absent Total laparoscopic uncut Roux-en-Y gastrojejunostomy after distal gastrectomy. Am Surg. 2014;80:E51-3. PubMed Google Scholar 27. Shibata C, Kakyo M, Kinouchi M, Tanaka N, Miura K, Naitoh T, Ogawa H, Yazaki N, Haneda S, Watanabe K, Sasaki I. Results of modified uncut Roux-en-Y reconstruction after distal gastrectomy for gastric cancer..
BALTIMORE -- Endoscopic gastrojejunostomy revision (EGJR) appeared to be effective for arresting or reversing weight regain following Roux-en-Y gastric bypass surgery, according to a retrospective. Roux-en-Y Biliary Reconstruction David Lee Joohyun Kim DEFINITION Roux-en-Y hepaticojejunostomy (RYH) was described by Cesar Roux in 1926 to reconstruct drainage of the esophagus following a total gastrectomy. This configuration of the intestines has been applied for biliary reconstruction following bile duct excision. In the setting of liver transplantation, the RYH is an alternative t OBJECTIVE: Morbid obesity is associated with an increased risk of postoperative complications, including surgical site infections (SSIs). SSIs significantly impact length of hospital and health care costs. There is good evidence that wound protectors for digestive tract surgery decrease the incidence of SSIs, but to date it remains unclear if this provides benefit in Laparoscopic Roux-en-Y. As Roux-en-Y anastomoses have become popular with partial gastrectomies and Whipple's procedures, they too are prone to both forms of obstruction around the jejuno-jejunal Roux-en-Y anastomosis (Figs 2b and 5), possibly even more so