Case-control study of the efficacy of retrogastric Roux-en-Y choledochojejunostomy

Abstract

The traditional, retrocolic/antegastric Roux-en-Y choledochojejunostomy is technically complicated, and the incidence of postoperative complications remains high. Here we report the outcome of 59 consecutively treated patients (study group, SG) that underwent a new choledochojejunostomy method in which the jejunal loop is passed behind the antrum pyloricum (retrogastric route). A retrospective comparison was made between this group of patients and 187 patients (control group, CG) that underwent conventional Roux-en-Y choledochojejunostomy (antegastric route). Baseline clinicopathological characteristics were similar in both groups, except for the BMI, which was significantly higher in the SG. The time spent on constructing the anastomosis, as well as overall postoperative complications, did not differ between groups. Compared with the CG, the incidence of postoperative delayed gastric emptying was decreased in the SG, and the time elapsed before the patients’ first postoperative liquid food consumption was shorter. We ascribe these beneficial effects to the superiority of the modified, retropyloric choledochojejunostomy approach, and propose that this surgical technique is particularly suitable for obese patients, especially those with a short ascending bowel loop.

Ageing with Smartphones in Urban China

“…In terms of economic development, during the first decades of Communist rule, Shanghai was officially viewed as 'an unwelcome leftover from a humiliating and resented semi-colonial past'. 42 During that time Shanghai's assets, ranging from experts and skilled workers to factory machines, were 'dismantled' and reallocated to aid the development of other areas in the rest of China, while Shanghai's own growth was sharply restricted. 43 It was not until 1990, with the establishment of Pudong as an open area for development, 44 that Shanghai regained some of its socio-economic potential.…”

“…Meanwhile, in 2018, the amount of annual per capita disposable income in Shanghai was around 64,000 RMB (around £6,500). 42 The total disposable income in the average nuclear family was about 190,000 RMB (around £20,000), 43 meaning that the cost of raising one child will easily cost at least a decade of a couple's total disposable income. In practice, it is almost impossible to attain an accurate figure of actual expenses given a variety of 'implicit costs', including purchasing a more expensive flat in neighbourhoods with access to better educational resources.…”

“…41 In the system of ration coupons, each household could only receive a fixed and minimum amount of coupons/ tickets for basic food and items of daily life. 42 The purchase of goods required both cash and coupons. That is to say, without ration coupons you could not purchase any goods, even if you offered entirely cash.…”

Two‐step thermal decomposition mechanism of phosphogypsum for resource utilization

“…[ 3–5 ] So far, the utilization rate of phosphogypsum is less than 15%. [ 6 ] Hence, it is important to solve the issue of phosphogypsum treatment and disposal.…”

A Rare Case of Traumatic Leptomeningeal Cyst in Adult: Case Report

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