[The excluded jejunal loop in the shape of a question mark. A simplified technic]

The question mark-shaped loop is a simplified excluded loop which combines the advantages of being prepared as rapidly as the Tomoda procedure modified by Hivet and of having the same functional benefits as Roux's Y-shaped loop. It is essentially an omega-shaped loop the afferent segment of which is severed a few centimetres upstream of its higher point. The two sections can be sutured manually or with mechanical staplers. The loop can be brought up through the mesocolon as easily as the Y-shaped loop without dissection of the mesentery and can be used to re-establish continuity after total gastectomy. It can also be passed through the mesocolon and behind the stomach to perform hepato-jejunal anastomoses. Finally, it can be used for double or triple derivations in the conservative treatment of chronic pancreatitis.