Motility Disorders after Roux-en-Y Gastrojejunostomy
| Autor: | BaoLien Nguyen Tu, Keith A Kelly |
|---|---|
| Rok vydání: | 1994 |
| Předmět: |
medicine.medical_specialty
Abdominal pain Nutrition and Dietetics business.industry Endocrinology Diabetes and Metabolism medicine.medical_treatment digestive oral and skin physiology Prokinetic agent digestive system Roux-en-Y anastomosis humanities Surgery body regions Jejunum surgical procedures operative Bloating medicine.anatomical_structure medicine Duodenum Vomiting Gastrectomy medicine.symptom business |
| Zdroj: | Obesity surgery. 4(3) |
| ISSN: | 1708-0428 |
| Popis: | About 30% of patients who have a Roux-en-Y gastrojejunostomy after gastrectomy suffer from abdominal pain, nausea, vomiting of food and bloating made worse by eating. This syndrome, called the Roux stasis syndrome, is caused, in part, by a motility disorder of the Roux limb. Transection of the jejunum during the construction of the limb separates the limb from the natural small intestinal pacemaker located in the duodenum. Ectopic pacemakers then appear in the limb and trigger retrograde contractions in its proximal portion. These contractions slow transit through the limb and result in Roux stasis. Current nonsurgical treatment of the syndrome includes the use of prokinetic agents and intestinal pacing, neither of which has demonstrated long-term benefits. A near-total gastrectomy may speed upper gastrointestinal transit somewhat, but stasis in the Roux limb often persists. Our current approach aims at preventing the syndrome by the use of an ‘uncut’ Roux limb, an operation which preserves myoneural continuity between the duodenal pacemaker and the Roux limb and so prevents the appearance of ectopic pacemakers and stasis in the limb. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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