Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux

T. R. DeMeester, K. H. Fuchs, C. S. Ball, M. Albertucci, T. C. Smyrk, T. N. Marcus

Research output: Contribution to journalArticle

163 Scopus citations

Abstract

Existing Roux-en-Y bile diversion procedures for duodenogastric reflux coupled with distal gastric resection or antrectomy and vagotomy have varied success due to interruption of the physiologic relationships between stomach and duodenum, the reduction of the gastric reservoir, the side effects of vagotomy, and the effect of the Roux limb on gastric emptying. A new bile diversion procedure, suprapapillary Roux-en-Y duodenojejunostomy, was studied, which eliminates the need for gastric resection to prevent jejunal ulcers by preserving duodenal inhibition of gastric acid secretion and the protective effects of duodenal secretion on the surrounding mucosa. Experimentally, the incidence of jejunal ulceration was significantly decreased by the preservation of the proximal duodenum. Clinically, bile diversion by suprapapillary Roux-en-Y duodenojejunostomy alleviates symptoms of duodenogastric reflux disease without being ulcerogenic (in the presence of normal gastric secretion) or prolonging gastric emptying.

Original languageEnglish (US)
Pages (from-to)414-426
Number of pages13
JournalAnnals of surgery
Volume206
Issue number4
DOIs
StatePublished - Jan 1 1987

ASJC Scopus subject areas

  • Surgery

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    DeMeester, T. R., Fuchs, K. H., Ball, C. S., Albertucci, M., Smyrk, T. C., & Marcus, T. N. (1987). Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Annals of surgery, 206(4), 414-426. https://doi.org/10.1097/00000658-198710000-00003