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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 ...
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]
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]
Stomach Intestinal Pylorus-Sparing (SIPS) surgery is a type of weight-loss surgery. It was developed in 2013 by two U.S. surgeons, Daniel Cottam [ 1 ] from Utah and Mitchell S. Roslin from New York. [ 2 ]
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]
Simple cholecystectomy is suitable for type I patients. For types II–IV, subtotal cholecystectomy can be performed to avoid damage to the main bile ducts. Cholecystectomy and bilioenteric anastomosis may be required. Roux-en-Y hepaticojejunostomy has shown good outcome in some studies. [4]