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Roux-en-Y reconstruction following partial or complete gastrectomy for stomach cancer. [4] Roux-en-Y hepatico jejuno stomy used to treat (macroscopic) bile duct obstruction which may arise due to: a common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma) [5] a bile duct injury (e.g. cholecystectomy, iatrogenic, trauma)
The mini-gastric bypass uses the low set loop reconstruction and thus has rare chances of bile reflux. The MGB has been suggested as an alternative to the Roux-en-Y procedure due to the simplicity of its construction and is becoming more and more popular because of low risk of complications and good sustained weight loss.
Choledochal cysts are treated by surgical excision of the cyst with the formation of a roux-en-Y anastomosis hepaticojejunostomy/ choledochojejunostomy to the biliary duct. Future complications include cholangitis and a 2% risk of malignancy, which may develop in any part of the biliary tree. A recent article published in the Journal of Surgery ...
The surgery involves exposing the porta hepatis (the area of the liver from which bile should drain) by radical excision of all bile duct tissue up to the liver capsule and attaching a Roux-en-Y loop of jejunum to the exposed liver capsule above the bifurcation of the portal vein creating a portoenterostomy. [1]
These include mother-baby and SpyGlass cholangioscopes (to help in diagnosis by directly visualizing the duct as opposed to only obtaining X-ray images [13] [14] [15]) as well as balloon enteroscopes (e.g. in patients that have previously undergone digestive system surgery with post-Whipple or Roux-en-Y surgical anatomy). [16]
Performing a CDD may lead to a tension-filled surgical anastomosis, leading to bile leakage and jaundice. [6] There is also the possibility of active tumour growth obstructing the CBD. Alternative procedures could be considered, such as a Roux-en-Y hepaticojejunostomy (a connection made between the hepatic duct and the jejunum). [3]
This type of surgery was designed to overcome the shortcomings of jejunocolic bypass. First performed in 1969, it anastomoses the end of the proximal duodenum to the side of the distal ileum. However, owing to the possibility of reflux of ileal content to the blind loop, some surgeons doubted the effectiveness of this surgery. [5]
Combined restrictive and malabsorptive techniques are called gastric bypass techniques, of which Roux-en-Y gastric bypass surgery (RGB) is the most common. In this technique, staples are used to form a pouch that is connected to the small intestine , bypassing the lower stomach, the duodenum , and the first portion of the jejunum .