ROUX-EN-Y GASTROJEJUNOSTOMY




INDICATIONS



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The diversion of bile away from the gastric outlet that has been altered by pyloroplasty or some type of gastric resection may be indicated in an occasional patient with persistent and severe symptomatic bile gastritis.




PREOPERATIVE PREPARATION



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A firm diagnosis of postoperative reflux gastritis should be established. Endoscopic studies should demonstrate gross as well as microscopic evidence of severe gastritis of greater intensity than is routinely observed from the regurgitation of duodenal contents through an altered gastric outlet. A gastric analysis is performed in a search for evidence of previous complete vagotomy. Barium studies and serum gastrin determination are routinely performed. In addition to a firm clinical diagnosis of postoperative reflux bile gastritis, there should be evidence of persistent symptoms despite long-term intensive medical therapy. The operative procedure is designed to completely divert the duodenal contents away from the gastric outlet. Ulceration will occur unless the gastric acidity is controlled by a complete vagotomy combined with antrectomy.



Constant gastric suction by a nasogastric tube is maintained.




ANESTHESIA



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General anesthesia combined with endotracheal intubation is satisfactory.




POSITION



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The patient is placed in a supine position with the feet lower than the head.


Jan 6, 2019 | Posted by in CARDIOLOGY | Comments Off on ROUX-EN-Y GASTROJEJUNOSTOMY
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