Roux-en-y procedure and Postgastrectomy Syndrome

Posted by e-Medical PPT Friday, October 1, 2010
Operations that make use of a Roux-en-Y procedure
* Some gastric bypasses for obesity.
* Roux-en-Y reconstruction following partial or complete gastrectomy for stomach cancer.
* Roux-en-Y hepaticojejunostomy used to treat bile duct obstruction which may arise due to:
  • common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma)
  • bile duct injury (e.g. cholecystectomy, surgical misadventure, trauma)
  • an infection/inflammation (e.g. pancreatic pseudocyst)
* Roux-en-Y choledochojejunostomy - indications same as Roux-en-Y hepaticojejunostomy.

Complications of Postgastrectomy Syndrome
  • Afferent and efferent loop syndrome
  • Dumping syndrome
  • Alkaline reflux gastritis
  • Nutritional disturbance
  • Retained antrum syndrome
  • Marginal ulcer
  • Postvagotomy diarrhea
  • Postvagotomy atony
  • Incomplete vagal transection
Gastric dumping syndrome is a condition where ingested foods bypass the stomach too rapidly and enter the small intestine largely undigested. Early dumping begins concurrently or immediately succeeding a meal. Symptoms of early dumping include nausea, vomiting, bloating, cramping, diarrhea, dizziness and fatigue. "Late" dumping happens 1 to 3 hours after eating. Symptoms of late dumping include weakness, sweating, and dizziness. Many people have both types. The syndrome is most often associated with gastric surgery.
People with this syndrome often suffer from hypoglycemia and it is referred to as "alimentary hypoglycemia".

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