Clinical and histological sequelae of Roux-en-Y diversion.
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.
Hollands
M J
MJ
Department of Surgery, United Medical School of Guy's Hospital, London, UK.
Filipe
I
I
Edwards
S
S
Brame
K
K
Maisey
M
M
Owen
W J
WJ
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