title: Modified "Roux en Y" hepaticojejunostomy to permit transgastric endoscopic access.
abstract: To present an option technique during the accomplishment of a "Roux-en-Y" hepaticojejunostomy that, allows future transgastric endoscopic access to the biloenteric anastomosis.
  
  
  
  The side-to-side "Roux-en-Y" hepaticojejunostomy is carried through transmesocolic, retrogastric short tunnel. A distal jejunal loop of approximately 10,0 to 15,0 cm must be kept far from the anastomosis that allows its setting, without tension, in the anterior gastric wall bellow the small bending, between body and of the stomach antrum. Once the jejunal segment is fixed on the anterior gastric wall, this will allow future endoscopic access to the bilioenteric anastomosis, carried through transgastric punction guided by endoscopic-ultrasound (EUS).
  
  
  
  The modified "Roux en Y" hepaticojejunostomy is a simple and new technique to permit an alternative transgastric endoscopic access to bilioenteric anastomosis.
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: André de
authors.initials: Ad
authors.lastname: Moricz
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Otavio Schimdt
authors.initials: OS
authors.lastname: Azevedo
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Tércio De
authors.initials: TD
authors.lastname: Campos
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Rogério
authors.initials: R
authors.lastname: Colaiacovo
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Akiba
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Rodrigo Altenfelder
authors.initials: RA
authors.lastname: Silva
authors.affiliation: Faculty of Medical Sciences, Santa Casa School of Medicine, São Paulo, Brazil.
authors.forename: Adhemar Monteiro
authors.initials: AM
authors.lastname: Pacheco
mesh_terms: D000713:Anastomosis, Roux-en-Y / Q000379:methods*; D016099:Endoscopy, Gastrointestinal; D006801:Humans; D007583:Jejunum / Q000601:surgery*; D013270:Stomach / Q000601:surgery*