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Roux-en-Y hepaticojejunostomy or choledochojejunostomy with gastrojejunostomy as palliation for irresectable pancreatic head cancer. [8] References
Jejunostomy is the surgical creation of an opening (stoma) through the skin at the front of the abdomen and the wall of the jejunum (part of the small intestine).It can be performed either endoscopically, or with open surgery.
Jejunojejunostomy is a surgical technique used in an anastomosis between two portions of the jejunum. [1] It is a type of bypass occurring in the intestine . It may lead to marked reduction in the functional volume of the intestine.
Billroth II, more formally Billroth's operation II, is an operation in which a partial gastrectomy (removal of the stomach) is performed and the cut end of the stomach is closed.
Numerous studies show that the loop reconstruction (Billroth II gastrojejunostomy) works more safely when placed low on the stomach, but can be a disaster when placed adjacent to the esophagus. Today thousands of "loops" are used for surgical procedures to treat gastric problems such as ulcers, stomach cancer, and injury to the stomach.
A Puestow procedure is indicated for the treatment of symptomatic chronic pancreatitis patients with pancreatic ductal obstruction and a dilated main pancreatic duct.
Radiation enteritis and scarring from marginal gastrojejunostomy ulceration are the causes of mechanical blockage of the intramural area. [7] [8] Conditions that cause external compression include internal hernia, volvulus, entrapment, compression, kinking of the afferent loop, postoperative adhesion, and intussusception of the afferent loop.
The loop should be long enough and should have a Braun jejunojejunostomy between the ascending and the descending loop. [9] The last 4 to 5 cm of the stapler line towards the greater curvature should be excised with the help of an electrocautery device in order to form a slim opening for the subsequent gastrojejunostomy. [9]