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

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.