Small bowel transit and gastric emptying after biliodigestive anastomosis using the uncut jejunal loop.
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.
Klaus
Alexander
A
Department of Surgery, Mayo Clinic Jacksonville, Jacksonville, FL 32224, USA.
Hinder
Ronald A
RA
Nguyen
Justin H H
JH
Nelson
Kevin L
KL
D000713:Anastomosis, Roux-en-Y; D000818:Animals; D002768:Choledochostomy / Q000379:methods; D003135:Common Bile Duct / Q000473:pathology; D005746:Gastric Emptying; D005772:Gastrointestinal Transit; D007205:Indium Radioisotopes; D007421:Intestine, Small / Q000502:physiology*; D007583:Jejunum / Q000601:surgery*; D008099:Liver / Q000473:pathology; D008297:Male; D019275:Radiopharmaceuticals; D051381:Rats; D011917:Rats, Inbred Lew; D012117:Resins, Synthetic; D019780:Technetium Tc 99m Lidofenin
D007205:Indium Radioisotopes; D019275:Radiopharmaceuticals; D012117:Resins, Synthetic; D019780:Technetium Tc 99m Lidofenin; C046797:amberlite