Related Experiment Videos
Isoperistaltic jejunal interposition for intractable postgastrectomy alkaline reflux gastritis
J S Aranow1, J B Matthews, J Garcia-Aguilar
1Department of Surgery, Beth Israel Hospital, Boston, MA 02215, USA.
Background:
The Roux-en-Y gastrojejunostomy is a popular method in the operative treatment of alkaline reflux gastritis and other postgastrectomy sequelae, but is associated with a high incidence of the so-called "Roux stasis syndrome." The Henley jejunal interposition has been used occasionally, albeit not widely, as an alternative to the Roux-en-Y reconstruction.
Study Design:
Six patients underwent Henley gastrojejunoduodenostomy to treat severe (Visick grade IV) symptoms following Billroth I and II procedures for peptic ulcer disease. All interposed jejunal segments were 40 cm in length and isoperistaltic in orientation. All patients had follow-up examination and telephone interview (mean 4.3 years, range 2.2 to 7.8 years).
Results:
All patients noted dramatic improvement after remedial surgery in the first year of follow-up. After the first postoperative year, all patients remained virtually symptom-free (Visick grade I and II) with no complaints of gastrojejunal stasis or bile acid reflux.
Conclusions:
This experience suggests that the Henley jejunal interposition is our effective method of treating reflux gastritis and is not associated with the poor emptying frequently associated with the Roux-en-Y reconstruction.