Isoperistaltic jejunal interposition for intractable postgastrectomy alkaline reflux gastritis

J Am Coll Surg. 1995 Jun;180(6):648-53.

Abstract

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.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Bile Reflux / etiology
  • Bile Reflux / surgery*
  • Female
  • Gastritis / etiology*
  • Humans
  • Jejunum / surgery*
  • Male
  • Middle Aged
  • Peptic Ulcer / surgery
  • Postgastrectomy Syndromes / surgery*
  • Postoperative Complications