A new biliodigestive anastomosis technique to prevent reflux and stasis
| Autor: | Alexander Klaus, Raimund Margreiter, Helmut Weiss, Claudia Neher, Angelika Eigentler, Heinz Pernthaler, Alfons Kreczy |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Liver Cirrhosis
Male medicine.medical_specialty Cholangitis Jejunostomy Motility Anastomosis Gastroenterology Statistics Nonparametric Surgical anastomosis Postoperative Complications Fibrosis Internal medicine Duodenogastric Reflux Occlusion medicine Animals Rats Wistar Cholecystostomy business.industry Electromyography Reflux Anastomosis Roux-en-Y General Medicine medicine.disease Roux-en-Y anastomosis Surgery Rats Jejunum Bacterial Translocation business Gastrointestinal Motility |
| Zdroj: | American journal of surgery. 182(1) |
| ISSN: | 0002-9610 |
| Popis: | Background: The Roux-en-Y procedure for biliodigestive drainage is most widely accepted, but 10% to 15% of patients postoperatively suffer from a blind-loop syndrome or cholangitis due to motility disorders. A new biliodigestive technique is evaluated in a rat model to prevent these complications. Methods: This experimental study in Wistar rats compares the Roux-en-Y technique with a new biliodigestive anastomosis creating a jejunal loop with luminal occlusion. Clinical parameters, small bowel motility, bacteriologic growth, and liver histopathology were evaluated in native and postoperative animals within a study period of 180 days. Results: Both operative procedures were well tolerated. After 6 months intense fibrosis of the liver and high-grade purulent cholangitis were observed in animals in the Roux-en-Y group. In these animals enterobacter and enterococci overgrowth was found. Myoelectric small bowel recordings revealed significant impairment of slow-wave frequency, aboral velocity, and action potentials (percentage of phase III) in Roux-en-Y animals. Conclusions: Motility disorders after conventional Roux-en-Y biliodigestive anastomosis are pivotal for histomorphological damage and infectious findings and can be prevented by using the new technique to create a jejunal loop with luminal occlusion. |
| Databáze: | OpenAIRE |
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