Roux-en-Y Procedure for Recurrent Ulcer, Bile Reflux and Dumping Syndrome following Antiulcer Gastric Surgery

Vassilakis, John Sophocles; Xynos, Evaghelos; Neonakis, E.; Noussis, G.; Androulakis, George

doi:10.1159/000171849

Cited by 8 publications

(8 citation statements)

References 24 publications

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“…Quantitation of the enterogastric reflux was assessed by 99m Tc-HIDA (hepatobiliary iminodiacetic acid) scintigraphy and gastric emptying rates for liquid and solid test meals were measured on separate occasions, using radionuclide labelling techniques as described previously by the authors for various types of antiulcer gastric surgery [22][23][24][25][26]. In brief, after ingestion of a standard solid test meal intragastric motility was measured repeatedly with a Á-camera (G.E.…”

Section: Assessment Of Long-term Resultsmentioning

confidence: 99%

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

Petrakis¹,

Vassilakis²,

Vrachassotakis³

et al. 1999

Eur Surg Res

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Background: Recently, gastric stapling with posterior truncal vagotomy has been performed by laparoscopic surgery, as an alternative to highly selective vagotomy (HSV) and the Taylor procedure for the treatment of chronic duodenal ulcer. Aim: To investigate, after a mean 5-year follow-up, the effect of the stapling-modified laparoscopic Taylor procedure, on gastric secretion, emptying and reflux as well as clinical parameters and recurrence rates in patients treated for duodenal ulcer. Methods: 16 patients, aged 38–66 years, were treated from January 1993 to January 1996 (median 60.5 months), by the laparoscopic stapling-modified Taylor procedure, using the Endo-GIA stapler device. Assessment of the results of gastric acid secretion, solid and liquid gastric emptying, enterogastric reflux, endoscopic findings and clinical parameters, using the Visick grading, was performed. Results: Endoscopy found healing ulcer in 15 patients. One patient showed signs of chronic ulcerative disease without gastritis or pyloric stenosis indicative of progressive ulcerative diathesis and was classified as Visick III. 14 patients were classified as Visick I and 1 as II. The enterogastric reflux index ranged from 0 to 26%, basal and peak acid output were 1.4 ± 0.6 and 11.7 ± 6.1 mmol H⁺/h, respectively. The half-emptying times of the solid and liquid meal were 82 ± 7 and 16 ± 6 min, respectively. These results are likely to be similar to those obtained from series of patients who underwent HSV or Taylor procedure and are closed to those from healthy controls. Conclusions: The laparoscopic modified Taylor procedure, using the Endo-GIA stapler device allows a more rapid, technically easier and radical performance of the operation with excellent long- term results and should be included in the armamentarium of the treatment of chronic duodenal ulcer.

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Section: Assessment Of Long-term Resultsmentioning

confidence: 99%

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

Petrakis¹,

Vassilakis²,

Vrachassotakis³

et al. 1999

Eur Surg Res

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“…Lack of coordination between the vagotomized gastric remnant and the malfunctioning efferent jejunal limb, which has been dissociated from its natural pacesetter at the proximal duo-denum, may account for the abnormally delayed emptying. 21 The motor abnormalities of the efferent jejunal limb, which have been manometrically detected in symptomatic patients, 6,8 include absence or abnormal periodicity and often disruption of the migrating motor complex. During the fasting state, high-amplitude contractions may also be observed.…”

Section: Commentmentioning

confidence: 99%

“…The aim of the present study was to test the effect of intravenous erythromycin on gastric emptying of solids in patients who had undergone a Roux-en-Y gastrojejunostomy as the remedial procedure for reflux gastritis syndrome and/or dumping syndrome 21,22 after an antiulcer operation (either TVP or Billroth II gastrectomy).…”

mentioning

confidence: 99%

Enhancement of Gastric Emptying of Solids by Erythromycin in Patients With Roux-en-Y Gastrojejunostomy

Petrakis¹

1998

Arch Surg

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Background: Roux-en-Y reconstruction is sometimes associated with symptoms that suggest food stasis, as a result of dysmotility of either the gastric remnant and/or the efferent jejunal limb. Objective: To study the possible effect of intravenous erythromycin lactobionate on gastric emptying of solids in patients who have undergone a Roux-en-Y procedure. Patients: Twenty-four patients with a Roux-en-Y procedure participated in the study. Ten of them had undergone truncal vagotomy with pyloroplasty; the remaining 14 had undergone a Billroth II subtotal gastrectomy as the initial antiulcer procedure. Sixteen healthy subjects served as controls. Methods: All healthy subjects and patients underwent assessment of gastric emptying of a standard radiolabeled solid meal after administration of placebo or 200 mg of erythromycin lactobionate intravenously. Scanning was done with a gamma camera, and emptying curves were constructed. From these curves the half-time of gastric emptying was calculated. Results: Patients with severe symptoms of gastric stasis had a significantly longer half-time than did patients with mild or no symptoms (P = .002). Patients with a Billroth II subtotal gastrectomy as the initial antiulcer procedure had a significantly worse grade of symptoms (P = .01) and a significantly prolonged half-time (P = .02) compared with patients with a truncal vagotomy with pyloroplasty as the initial antiulcer procedure. Erythromycin significantly reduced the half-time in the controls (PϽ.001) and all patients after Roux-en-Y procedure (PϽ.001). Conclusion: Erythromycin could be a useful prokinetic drug in patients with Roux stasis syndrome.

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“…Στην Roux-en-Y εγχείρηση ή απιούσα έλικα που πριν λειτουργούσε με ένα ρυθμό 12κύκλων/Γηίη από το βηματοδότη του δωδεκαδάκτυλου αναστομώνε-ται με το κολόβωμα του στομάχου που παρουσιάζει ένα διαφορετικό ρυθμό μυοηλεκτρικής δραστηριότητας 3κύκλων/ητ»η με αποτέλεσμα την έλλειψη συ νεργασίας και συγχρονισμού μεταξύ στομάχου και απιούσας έλικας [211,316].…”

Section: απουσία φάσης IIIunclassified

“…Μυοηλεκρικές διαταραχές ενοχοποιούνται για την παθογένεση της γαστρικής στάσης μετά από Roux-en-Y γαστρεκτομή και την δημιουργία του γνωστού συνδρό μου Roux. Η έλλειψη του συντονισμού μεταξύ του βογοτομηθέντος γαστρικού κολοβώματος και της απιούσας νηστιδικής έλικας, λόγω αποκοπής της τελευταίας από τον φυσικό της βηματοδότη στο κεντρικό δωδεκαδάκτυλο, μπορεί να ενοχοποιηθεί για την ανωμαλία της καθυστερημένης γαστρικής κένωσης [211]. Στην Roux-en-Y γαστρονηστιδική αναστόμωση ή απιούσα έλικα που πριν λειτουργούσε με ένα ρυθμό 12κύκλων/ιτιΐη από το βηματοδότη του δωδεκαδάκτυλου αναστομώνεται με το κολόβωμα του στομάχου που παρουσιάζει ένα διαφορετικό ρυθμό μυοηλεκρικής δρα στηριότητας 3κύκλων/πηϊη με αποτέλεσμα την έλλειψη συνεργασίας και συγχρονι σμού μεταξύ στομάχου και απιούσας έλικας [211].…”

Section: θεραπεια των κινητικων διαταραχων του στομαχουunclassified

Η Δραση Της Ερυθρομυκινης Στη Γαστρικη Κενωση Του Ακεραιου Και Χειρουργημενου Στομαχου

Πετρακησ¹

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Τόμος 8, συμπληρωματικό τεύχος 1995. 5.) Η Συμβολή της Θωρακοσκοπικής Χειρουργικής στη διάγνωση και θερα πεία των παθήσεων του Πνεύμονα και του Μεσοθωρακίου. Η Εμπειρία μας σε 32 περιπτώσεις. Κουτσούμπη Ε. Επανωμεριτάκης Ε. Μαλλιωτάκης Α. Πετράκης Ι. Δροσίτης Ι. Χαλκιαδάκης Γ. 8° Πανελλήνιο Συνέδριο Νοσημάτων Θώρακος. Αθήνα 14-17 Μαρτίου 1996. Abstr. 183. Ανακοίνωση Δημοσιευμένη στο Πνεύμων συμπληρωματικό τεύχος. 6.) Η δράση της Ερυθρομυκίνης στην κινητικότητα του σώματος του οισο φάγου υγείων εθελοντών.

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Roux-en-Y Procedure for Recurrent Ulcer, Bile Reflux and Dumping Syndrome following Antiulcer Gastric Surgery

Cited by 8 publications

References 24 publications

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

Laparoscopic Modified Taylor Procedure in the Treatment of Duodenal Ulcer: Technique and Outcome after 5-Year Follow-Up

Enhancement of Gastric Emptying of Solids by Erythromycin in Patients With Roux-en-Y Gastrojejunostomy

Η Δραση Της Ερυθρομυκινης Στη Γαστρικη Κενωση Του Ακεραιου Και Χειρουργημενου Στομαχου

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