Mechanisms and clinical management of small bowel obstruction caused by kinking of the jejunojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass
10.3760/cma.j.cn112139-20231130-00247
- VernacularTitle:Roux-en-Y胃旁路术后空肠吻合口扭结的发生机制与临床处理
- Author:
Yang SHI
1
;
Ke CAO
;
Zhenjun WANG
;
Jiagang HAN
Author Information
1. 首都医科大学附属北京朝阳医院普外科，北京 100020
- Keywords:
Obesity;
Gastric bypass;
Roux-en-Y gastric bypass;
Kinking of the jejunojejunal anastomosis;
Metabolic and bariatric surgery
- From:
Chinese Journal of Surgery
2024;62(5):457-461
- CountryChina
- Language:Chinese
-
Abstract:
Currently, obesity and its complications have become increasingly serious health issues. Bariatric surgery is an effective method of treating obesity and related metabolic complications. Among them, Roux-en-Y gastric bypass (RYGB) is still considered the “gold standard” procedure for bariatric surgery. Small bowel obstruction is one of the possible complications after RYGB, and in addition to the formation of intra-abdominal hernias, kinking of the jejunojejunal anastomosis is an important cause of small bowel obstruction. The early clinical symptoms of kinking of the jejunojejunal anastomosis often lack clarity in the early stages. Therefore, early diagnosis, prevention, and effective treatment of kinking of the jejunojejunal anastomosis are challenging but crucial. The occurrence of kinking of the jejunojejunal anastomosis may be related to surgical techniques and the surgeon′s experience. The use of anti-obstruction stitch, mesenteric division, and bidirectional jejunojejunal anastomosis may be beneficial in preventing kinking of the jejunojejunal anastomosis. If kinking of the jejunojejunal anastomosis occurs, timely abdominal CT scans and endoscopic examinations should be performed. Gastric and intestinal decompression should be initiated immediately, and exploratory surgery should be prepared.
