Roux-en-Y biliary diversion: a worthwhile procedure?
The Roux-en-Y biliary diversion has varied in popularity, with poor results recently reported. A retrospective case note review was undertaken of all patients who underwent Roux-en-Y diversion, in a single consultant practice to assess a single clinician's results. Thirty-seven consecutive patients who underwent biliary diversion were studied: 22 had gastric malignancy and 15 had benign biliary reflux. The benign group revealed improvement in 80% with 40% being entirely asymptomatic and 66% being medication free. In the malignant disease group 15 patients were Visick grade I or II post-operatively; two were classified as Visick IV but one was converted to grade I after further gastric resection. The 30-day mortality in this group was 14 and 50% at 5 years. Good or satisfactory results can be obtained from Roux-en-Y biliary diversion for patients with benign (80% satisfied) and malignant (84% satisfied) disorders but care with patient selection in the benign group is required.
Skinner
P P
PP
Department of Surgery, Northern General Hospital Trust, Sheffield, UK.
Smith
J A
JA
D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000706:statistics & numerical data; D001655:Bile Reflux / Q000453:epidemiology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D018579:Patient Selection; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome