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

Am J Surg. 2003 Dec;186(6):747-51. doi: 10.1016/j.amjsurg.2003.08.025.

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. (99)Technetium HIDA and (111)Indium-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 (99)Tc-HIDA and (111)In 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.

MeSH terms

  • Anastomosis, Roux-en-Y
  • Animals
  • Choledochostomy* / methods
  • Common Bile Duct / pathology
  • Gastric Emptying
  • Gastrointestinal Transit*
  • Indium Radioisotopes
  • Intestine, Small / physiology*
  • Jejunum / surgery*
  • Liver / pathology
  • Male
  • Radiopharmaceuticals
  • Rats
  • Rats, Inbred Lew
  • Resins, Synthetic
  • Technetium Tc 99m Lidofenin

Substances

  • Indium Radioisotopes
  • Radiopharmaceuticals
  • Resins, Synthetic
  • Technetium Tc 99m Lidofenin
  • amberlite