The Letton-Q modified Roux-en-Y

Roux-en-Y enteric diversion is useful for correction of alkaline reflux gastritis consequent to loop gastro-enterostomy, in the treatment of spontaneous enterogastric reflux and esophagitis, and in the configuration of primary peptic ulcer surgery. Construction of the Roux-en-Y, however, may be technically difficult or hazardous and is time consuming. Conversion of a loop gastroenterostomy into Roux-en-Y topology by umbilical tape ligation of the afferent limb and jejunojejunostomy was reported by A. Hamblin Letton in 1978. With the availability of stapling devices, the Letton procedure acquires new significance as an attractive alternative to the classic Roux-en-Y.