title: Clinical and histological sequelae of Roux-en-Y diversion.
abstract: Nine post-Polya gastrectomy patients with symptoms of reflux gastritis were studied immediately before and 6 months after Roux-en-Y diversion with a 60 cm jejunal loop. Endoscopy, histology, HIDA radionuclide studies and acid secretory studies were performed to determine the effect of Roux-en-Y diversion. Symptomatic results were pleasing in that all patients were graded as Visick I or II. There was a statistically significant improvement in endoscopic evidence of mucosal damage (median score of 6 reduced to median of 1) and visible bile reflux (median score of 10.5 reduced to 0). Foveolar hyperplasia, superficial chronic gastritis and histological precursors of malignancy all improved. There was a significant decrease in the reflux of 99mTc-labelled HIDA into the gastric remnant while acid secretion remained unchanged. Roux-en-Y diversion with a 60 cm jejunal loop provides not only symptomatic relief but scintigraphic, endoscopic and histological evidence of pancreatobiliary diversion.
authors.affiliation: Department of Surgery, United Medical School of Guy's Hospital, London, UK.
authors.forename: M J
authors.initials: MJ
authors.lastname: Hollands
authors.forename: I
authors.initials: I
authors.lastname: Filipe
authors.forename: S
authors.initials: S
authors.lastname: Edwards
authors.forename: K
authors.initials: K
authors.lastname: Brame
authors.forename: M
authors.initials: M
authors.lastname: Maisey
authors.forename: W J
authors.initials: WJ
authors.lastname: Owen
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001655:Bile Reflux / Q000473:pathology / Q000601:surgery; D003258:Consumer Behavior; D004383:Duodenogastric Reflux / Q000473:pathology / Q000601:surgery*; D004724:Endoscopy; D005260:Female; D005743:Gastrectomy; D005756:Gastritis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery; D013270:Stomach / Q000473:pathology