Summary:
Loop gastro-Jejunostomy and Roux-en-Y gastro-
Jejunostomy, the commonest reconstructions in gastric
surgery, are significantly associated with alkaline reflux
gastritis and Roux stasis syndrome (RSS) respectively. The
Modified Uncut Roux-en-Y (MUREY) technique could be
an effective technique in preventing both the conditions.
This prospective observational study was designed to
evaluate the effectiveness of Modified UREY reconstruction
to prevent RSS and Alkaline reflux gastro-esophagitis while
avoiding “Staple- line dehiscence”. A total of 47 patients
of gastric outlet obstruction, both benign and malignant,
undergoing Modified Uncut Roux-en-Y reconstruction with/
without Gastrectomy at BMCH over the span of July 2014
to July 2016, were incorporated in this study. Patients were
followed up from the immediate post-operative periods till
discharge and postoperatively for 2 months.
There was no incidence of bile reflux or bilious vomiting
in the follow-up period. There were two (4.3%) incidences
of RSS among the 47 patients (P<0.001). Postoperative
endoscopy was carried out in 9 patients to assess the
integrity of staple line occlusion which revealed normal
looking mucosa of upper GIT with an intact staple line
occlusion. There was significant decrease in the average
Visick score, from 3.5±0.6 (SD) preoperatively to
1.2±0.4(SD) in the post-operative period. Average increase
in the body weight at the time of final follow-up was
6.7%±5.1 kg.
The Modified “Uncut Roux-En-Y” reconstruction technique
is bothfeasible and safe. It is effective in preventing RSS
and alkaline reflux gastritis while preventing Staple-line
dehiscence and, can be a preferred technique of gastric
bypass.
Keywords: Modified Uncut Roux-en-Y (MUREY), Roux
Stasis Syndrome (RSS), Biliary reflux.
(J Bangladesh Coll Phys Surg 2018; 36: 139-144)
DOI: http://dx.doi.org/10.3329/jbcps.v36i4.36085