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: 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*

Pancreatic cancer has been identified as one of the most common malignant causes of upper gastrointestinal obstruction. Most common sites of obstruction include the pyloric region and second and third portions of the duodenum. If surgical gastrojejunostomy is not a viable option, metallic stent placement may be performed either by transoral or transgastric approach. Transgastric technique is considered to be more invasive and is often employed only in failed attempts to insert a stent using transoral technique. This report presents a 70-year-old patient with pancreatic cancer involving the proximal jejunum. Although this is a rarely described location for stenting, the patient was successfully treated using transgastric technique.
Aged ; Duodenum ; Fluoroscopy ; Gastric Bypass ; Humans ; Jejunum ; Pancreatic Neoplasms ; Stents*

Heterotopic pancreas is an aberrant pancreatic tissue that lacks anatomic and vascular continuity with the main pancreas. Although heterotopic pancreas is a relatively rare entity and usually noted as an incidentel findings at autopsy and during surgery for other causes, it is capable of producing symptoms depending on the site and size of lesions as well as various pathological changes occuring in the pancreas itself. We have recently experienced a case of heterotopic pancreas on the mid-body of posterior wall along the lesser curvatrue of stomach in a 30-year-old man, who visited our hospital for the evaluation of postprandial epigastric discomfort and indigestion for two months. Gastrofiberoscopy revealed a 3x4 cm sized submucosal mass, and subtotal gastrectomy gastrojejunostomy was performed and he was discharged without any postoative complication.
Adult ; Autopsy ; Dyspepsia ; Gastrectomy ; Gastric Bypass ; Humans ; Pancreas* ; Stomach