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Related Experiment Videos

Vomiting after Roux-en-Y biliary diversion: relationship to surgical technique.

G H Ferguson1, M Rose, I MacLennan

  • 1Department of Surgery, Manchester Royal Infirmary, UK.

The British Journal of Surgery
|May 1, 1990
PubMed
Summary

Vomiting after Roux-en-Y diversion surgery is often linked to gastric stasis. A dependent sump in the surgical technique significantly increases the likelihood of vomiting and delayed gastric emptying.

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Area of Science:

  • Gastroenterology
  • Surgical Outcomes
  • Digestive System Physiology

Background:

  • Vomiting is a common complication following revisional gastric surgery, particularly Roux-en-Y biliary diversion.
  • This complication is frequently attributed to delayed gastric emptying (gastric stasis) or stasis within the jejunal limb of the Roux-en-Y reconstruction.

Purpose of the Study:

  • To investigate the relationship between gastric emptying, surgical technique, and the incidence of vomiting after Roux-en-Y diversion.
  • To identify specific surgical factors contributing to poor outcomes in patients experiencing post-operative vomiting.

Main Methods:

  • A study involving 33 patients who underwent Roux-en-Y diversion (10 with satisfactory outcomes, 23 with unsatisfactory outcomes) and 12 healthy controls.
  • Utilized a radiolabeled semisolid meal to assess gastric and jejunal emptying.

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  • Patient outcomes were evaluated using the modified Visick grading system.

    • Main Results:

    • Seven patients with frequent vomiting exhibited gastric stasis, and two showed delayed emptying in the jejunal limb.
    • Vomiting was significantly more probable in patients with a dependent sump (P < 0.006).
    • Gastric emptying was notably prolonged in patients with a dependent sump (P = 0.0009).

    Conclusions:

    • A dependent sump, a result of surgical technique, is strongly associated with increased vomiting and delayed gastric emptying after Roux-en-Y diversion.
    • Addressing surgical technique to avoid a dependent sump may improve outcomes and reduce post-operative vomiting.