The cut-closed-reconnected Roux loop

Kummer, Erik W; Gerritsen, Josephus J.; Brummelkamp, W. H.

doi:10.1016/s0002-9610(00)00246-4

Cited by 7 publications

(2 citation statements)

References 16 publications

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“…It became obvious that the sole use of staples does not result in a durable closure of the uncut Roux loop in some patients. In order to ensure its permanent closure, the so-called ‘cut-closed-reconnected’ Roux loop has been proposed, which included the transection and closure of the afferent limb with the cutting linear stapler [17]. A technique employing a nonabsorbable material was previously shown to prevent small-bowel recanalization in an animal model [18].…”

Section: Discussionmentioning

confidence: 99%

Pancreatoduodenectomy with Subtotal Stomach-Preserving and Uncut Roux Reconstruction

Post¹,

Wrzesinski²,

Klek³

et al. 2011

Eur Surg Res

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Background/Purpose: Pylorus-preserving pancreatoduodenectomy (PD) has become the therapy of choice for resectable tumors located in the head of the pancreas and periampullary region. In addition, a distal gastrectomy may still be required for tumors located in the dorsal part of the pancreatic head or when there is evidence of proximal duodenal invasion. This may lead to postoperative complications, including gastric dumping, marginal ulceration, and bile reflux gastritis. This study reports on the postoperative course following subtotal stomach-preserving PD with the uncut Roux reconstruction diverting biliary and pancreatic secretions from the gastric remnant. Methods: A technique combining subtotal stomach-preserving PD with the uncut Roux reconstruction was applied in 10 patients. The postoperative clinical follow-up data are reviewed, and clinical criteria of biliary gastric reflux and gastritis were evaluated. Results: The postoperative course was uneventful in 4 patients and complicated in 6 patients. Delayed gastric emptying occurred in 3 patients. No deaths occurred in the postoperative period. One patient suffered from occasional nausea with abdominal discomfort for which endoscopy and cholescintigraphy were performed. Endoscopy confirmed complete occlusion of the afferent jejunal limb and showed marginal ulceration within the gastrojejunal anastomosis. Cholescintigraphy showed signs of enterogastric reflux. The check-up endoscopy following typical antisecretory therapy revealed complete ulcer healing. Four patients died of tumor recurrence 6, 7, 8, and 12 months following surgery. Conclusion: This pilot study suggests that the uncut Roux reconstruction may represent a good alternative to gastrointestinal reconstruction following PD. Further studies including the determination of intragastric bile acid concentration and radionuclide isotope scanning in a larger number of patients are warranted.

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Section: Discussionmentioning

confidence: 99%

Pancreatoduodenectomy with Subtotal Stomach-Preserving and Uncut Roux Reconstruction

Post¹,

Wrzesinski²,

Klek³

et al. 2011

Eur Surg Res

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“…1). We reported the promising short-term results of this procedure in 2000 [8]. The CCR-Roux procedure is based on the assumption that the peristalsis in the afferent limb aborally of the reconnection is identical to the peristalsis after an end-to-end anastomosis and therefore better than in the Roux-Y reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Long-Term Results of the Cut-Closed-Reconnected Roux Loop for Enterogastric Reflux

Kummer¹,

Gerritsen²,

Klaase³

2010

Dig Surg

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Background: The aim of this study was to present the long-term results of the cut-closed-reconnected (CCR)-Roux procedure for reflux gastritis. Methods: A retrospective analysis was performed on 14 patients with proven reflux gastritis and/or esophagitis who were treated at our institution with a CCR-Roux procedure between 1992 and 1997. Results: The closure of the afferent loop in the CCR-Roux procedure is effective and permanent. The CCR-Roux patients did not need a rest gastrectomy. No signs of Roux stasis syndrome were seen. There was a consistent weight gain at 2 and 5 years of follow-up. These results permit a comparison with those of the Roux-Y procedure and other alternative procedures as well. Conclusion: In the long run, the CCR-Roux procedure is effective in the treatment of reflux gastritis.

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Small bowel transit and gastric emptying after biliodigestive anastomosis using the uncut jejunal loop

Alexander

Hinder

Nguyen

et al. 2003

The American Journal of Surgery

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The cut-closed-reconnected Roux loop

Cited by 7 publications

References 16 publications

Pancreatoduodenectomy with Subtotal Stomach-Preserving and Uncut Roux Reconstruction

Pancreatoduodenectomy with Subtotal Stomach-Preserving and Uncut Roux Reconstruction

Long-Term Results of the Cut-Closed-Reconnected Roux Loop for Enterogastric Reflux

Small bowel transit and gastric emptying after biliodigestive anastomosis using the uncut jejunal loop

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