Small bowel transit and gastric emptying after biliodigestive anastomosis using the uncut jejunal loop

Alexander Klaus, Ronald A. Hinder, Justin H.H. Nguyen, Kevin L. Nelson

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: The Roux-en-Y loop is an effective procedure for biliodigestive drainage. However, up to 15% of patients suffer from postoperative cholangitis or blind loop syndrome. A new technique to prevent motility abnormalities has been developed. Methods: Male Lewis rats were used to compare gastric emptying and transit in the small bowel after either a standard Roux-en-Y anastomosis or a new biliodigestive anastomosis technique which involves creating an "uncut" jejunal loop with luminal occlusion. Unoperated rats served as controls. 99Technetium HIDA and 111Indium-tagged amberlite were respectively used to investigate small bowel transit and gastric emptying. Results: Histopathology showed distinctive abnormalities only in the liver of conventional Roux-en-Y animals. No recanalization of the obliterated gut lumen occurred in uncut Roux animals. Distribution of 99Tc-HIDA and 111In showed were similar in both groups. Gastric emptying is slowed in both groups. Conclusions: The uncut proximal jejunum loop is a good alternative to the conventional Roux-en-Y loop and showed preserved small bowel motility and adequate jejunal transit. Gastric emptying is slowed in both groups.

Original languageEnglish (US)
Pages (from-to)747-751
Number of pages5
JournalAmerican journal of surgery
Volume186
Issue number6
DOIs
StatePublished - Dec 2003

Keywords

  • Biliodigestive anastomosis
  • Cholangitis
  • Motility
  • Roux-en-Y

ASJC Scopus subject areas

  • Surgery

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