Study on 175 patients underwent Roux-en-Y hepatico-jejunostomy on the Y ansa with subcutaneous intestinal extremities because of intrahepatic and extrahepatic stones. There was no postoperative death. Short-term outcomes were good in 64.57%, moderate in 27.2%, and poor in 8.00%. Long-term outcomes were good in 71.95%, moderate in 20.12%, and poor in 7.92%. Treatment for main stone by drain lavage was good in 25.22%, moderate in 28.00% and bad in 45.94%. Treatment for residual stone under image intensifier through intestinal head was good in 31.13%, moderate in 68.17% and bad in 0%. These findings showed that this technique is good in treating postoperative residual and recurrent stones
Gastric Bypass ; Surgery ; Therapeutics

Gastrectomy ; Gastric Bypass ; Humans

Gastritis cystica polyposa (GCP) is a rare lesion characterized by hyperplastic and cystic dilatation of the gastric mucous glands infiltrating into the underlying submucosa. A cumulative experience suggests that GCP represents a manifestation of a spectrum of reactive inflammatory responses to mucosal injury. The case reported herein is a GCP developed as multiple polypoid lesions with a circular arrangement in the gastric mucosae along the gastrojejunostomy site.
Dilatation ; Gastric Bypass ; Gastric Mucosa ; Gastritis*

No abstract available.
Airway Management* ; Gastric Bypass* ; Humans

No abstract available.
Airway Management* ; Gastric Bypass* ; Humans

The radiologic findings of prolapsed gastric mucosa through gastrojejunostomy stoma after gastrectomy is very characteristic, but recurrent gastric cancer, retrograde jejunogastric intussusception, and Hofmeister defect should be differentiated from it because of their simillar postoperative upper gastrointestinal series findings.The author reports 3 cases of prolapsed gastric mucosa through gastrojejunostomy stoma after Hofmeister's gastrectomy with brief review of the literature.
Gastrectomy ; Gastric Bypass ; Gastric Mucosa ; Intussusception ; Stomach Neoplasms

PURPOSE: The restoration of intestinal continuity following subtotal gastrectomy for gastric malignancy as well as benign gastric disease is an important area for research. The aim of this study was to compare the uncut Roux-en-Y reconstruction using a short Roux limb (20 to 30 cm) with the uncut Roux-en-Y reconstruction using a long Roux limb (more than 40 cm). METHODS: 48 patients (33 men and 15 women) underwent uncut Roux-en-Y reconstruction using a short Roux limb (short Roux limb group), and 32 patients (19 men and 13 women) had the Roux-en-Y operation using a long Roux limb (long Roux limb group). We assessed the outcome of these operations on the occurrence of Roux stasis syndrome, the endoscopic findings, and the required period for the nasogastric tube. RESULTS: Roux stasis syndrome occurred in 9 patients (18.8%) in the short Roux limb group, and in 10 patients (31.3%) in the long Roux limb group (p value 0.201). Pathological endoscopic finding were observed in 5 patients (10.4%) in the short Roux limb group, and in 6 patients (18.8%) in the long Roux limb group (p=0.292). CONCLUSION: Comparing the short Roux limb group with the long Roux limb group in uncut Roux-en-Y reconstruction after subtotal gastrectomy, We can conclude that uncut Roux-en-Yreconstruction using a short Roux limb is an effective reconstruction procedure to alleviate Roux stasis syndrome, reflux gastritis and esophagitis.
Esophagitis ; Extremities* ; Gastrectomy* ; Gastric Bypass* ; Gastritis ; Humans ; Male ; Stomach Diseases

In 1991, the author (H.Y.S.) reported the first case of self-expandable metallic stent (SEMS) placement in a patient with recurrent cancer after gastrojejunostomy. Since then SEMS placement has developed into a well-established method for the palliative treatment of malignant gastroduodenal obstruction. This year marks the 30th year the author has been implicated in the development of gastrointestinal SEMSs. Thus far, the author has developed successively a total of six generations of gastroduodenal SEMSs through trial and error over the years. In the present article, the author reviews his personal experience in developing gastroduodenal stents.
Family Characteristics ; Gastric Bypass ; Humans ; Methods ; Palliative Care ; Stents*

PURPOSE: Mechanical stapler is regarded as a good alternative to the hand sewing technique, when used in gastric reconstruction. The circular stapling method has been widely applied to gastrectomy (open orlaparoscopic), for gastric cancer. We illustrated and compared the hand-sutured method to the circular stapling method, for Billroth-II, in patients who underwent laparoscopy assisted distal gastrectomy for gastric cancer. MATERIALS AND METHODS: Between April 2009 and May 2011, 60 patients who underwent laparoscopy assisted distal gastrectomy, with Billroth-II, were enrolled. Hand-sutured Billroth-II was performed in 40 patients (manual group) and circular stapler Billroth-II was performed in 20 patients (stapler group). Clinicopathological features and post-operative outcomes were evaluated and compared between the two groups. RESULTS: Nosignificant differences were observed in clinicopathologic parameters and post-operative outcomes, except in the operation times. Operation times and anastomosis times were significantly shorter in the stapler group (P=0.004 and P<0.001). CONCLUSIONS: Compared to the hand-sutured method, the circular stapling method can be applied safely and more efficiently, when performing Billroth-II anastomosis, after laparoscopy assisted distal gastrectomy in patients with gastric cancer.
Gastrectomy ; Gastric Bypass ; Hand ; Humans ; Laparoscopy ; Stomach Neoplasms

BACKGROUND/AIMS: Performing endoscopic retrograde cholangiopancreatography (ERCP) in patients who have undergone Rouxen-Y gastric bypass (RYGB) is challenging. Standard ERCP and enteroscopy-assisted ERCP are associated with limited success rates. Laparoscopy- or laparotomy-assisted ERCP yields improved efficacy rates, but with higher complication rates and costs. We present the first multicenter experience regarding the efficacy and safety of endoscopic ultrasound (EUS)-directed transgastric ERCP (EDGE) or EUS. METHODS: All patients who underwent EDGE at two academic centers were included. Clinical success was defined as successful ERCP and/or EUS through the use of lumen-apposing metal stents (LAMS). Adverse events related to EDGE were separated from ERCP- or EUS-related complications and were defined as bleeding, stent migration, perforation, and infection. RESULTS: Sixteen patients were included in the study. Technical success was 100%. Clinical success was 90% (n=10); five patients were awaiting maturation of the fistula tract prior to ERCP or EUS, and one patient had an aborted ERCP due to perforation. One perforation occurred, which was managed endoscopically. Three patients experienced stent dislodgement; all stents were successfully repositioned or bridged with a second stent. Ten patients (62.5%) had their LAMS removed. The average weight change from LAMS insertion to removal was negative 2.85 kg. CONCLUSIONS: EDGE is an effective, minimally invasive, single-team solution to the difficulties associated with ERCP in patients with RYGB.
Cholangiopancreatography, Endoscopic Retrograde* ; Fistula ; Gastric Bypass ; Hemorrhage ; Humans ; Stents ; Ultrasonography*