Roux-en-Y anastomosis

Schematic of gastric bypass using a Roux-en-Y anastomosis. The transverse colon is not shown so that the Roux-en-Y can be clearly seen. The variant seen in this image is retrocolic, retrogastric, because the distal small bowel that joins the proximal segment of stomach is behind the transverse colon and stomach.

In general surgery, a Roux-en-Y anastomosis, less formally and precisely Roux-en-Y, is a surgically created (end-to-side) anastomosis. Typically, it is between stomach and small bowel that is distal (or further down the gastrointestinal tract) from the cut end.^[1]

Overview

The name is derived from the surgeon who first described it (César Roux)^[1] and the stick-figure representation. Diagramatically, the Roux-en-Y anastomosis looks a little like the letter Y; typically, the two upper limbs of the Y represent (1) the proximal segment of stomach and the distal small bowel it joins with and (2) the blind end that is surgically divided off, and the lower part of the Y is formed by the distal small bowel beyond the anastomosis.

Roux-en-Ys are used in several operations and collectively called Roux operations.^[1]

Operations that make use of a Roux-en-Y

• Some gastric bypasses for obesity.
• Roux-en-Y reconstruction following partial or complete gastrectomy for stomach cancer.^[2]
• Roux-en-Y hepaticojejunostomy used to treat (macroscopic) bile duct obstruction which may arise due to:
  • a common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma)^[3]
  • a bile duct injury (e.g. cholecystectomy, iatrogenic, trauma)
  • an infection/inflammation (e.g. pancreatic pseudocyst)
• Roux-en-Y choledochojejunostomy - indications same as Roux-en-Y hepaticojejunostomy.
• Roux-en-Y pancreas transplant ^[4]
• Roux-en-Y pancreas reconstruction after blunt abdominal trauma.^[5]

References

External links

• Anastomoses - thefreedictionary.com.