Antireflux status post Roux-en-Y anastomosis: An experimental study for optimal antireflux technique
| Autor: | Ajay Kumar Verma, Om Prakash Purbey, Shiv Narain Kureel, Archika Gupta, Anand Pandey, Kanoujia Sunil, Digamber Chaubey |
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| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Journal of Indian Association of Pediatric Surgeons, Vol 23, Iss 1, Pp 32-35 (2018) |
| Druh dokumentu: | article |
| ISSN: | 0971-9261 1998-3891 |
| DOI: | 10.4103/jiaps.JIAPS_75_17 |
| Popis: | Background: Roux-en-Y hepaticojejunostomy has been a gold standard to establish biliary-enteric anastomosis for various surgical indications, but associated with variable incidences of cholangitis. This experimental study was conducted to report a modification in Roux-en-Y anastomosis for possible better alternative to provide antireflux procedure after Roux-en-Y biliary-enteric anastomosis with the aim to minimize the possibility of reflux and its consequences. Materials and Methods: For experimental study, the required fresh segment of Lamb's small intestine was procured. Three sets of Roux-en-Y anastomosis were created for each experiment. In set 1, there was simple Roux-en-Y anastomosis. In set 2, Roux-en-Y anastomosis along with 4–5 cm long spur between the hepatic and duodenal limbs was created. In set 3, in addition to Roux-en-Y with creation of spur, additional antireflux mechanism was created at the junction of upper two-third and lower one-third of the hepatic limb. Saline mixed contrast was infused by infusion pump to raise the intraluminal pressure to more than 10 cm of H2O. X-ray was taken at that time. Results: In set 1, all preparations demonstrated reflux of contrast in the hepatic limb. The set 2 also demonstrated the same findings of 100% reflux in the hepatic limb. In set 3, No reflux was observed in 8 (80%) preparations while remaining 2 (20%) preparations reveal partial reflux. Conclusion: This experimental study suggests that the provision of spur and additional valve may be able to decrease the possibility of reflux in Roux-en-Y biliary-enteric anastomosis. |
| Databáze: | Directory of Open Access Journals |
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