Ann Surg 1994 May;219(5):451-5; discussion 455-7
Long-term follow-up of patients with Roux-en-Y gastrojejunostomy for gastric disease.
McAlhany JC Jr, Hanover TM, Taylor SM, Sticca RP, Ashmore JD Jr
Department of Surgical Education, Greenville Hospital System, South Carolina.
 

OBJECTIVE: A consecutive series of Roux-en-Y gastrojejunostomies with a mean follow-up of 11.9 years was reviewed to characterize the long-term results of patients having this operation to treat or prevent bile reflux gastritis.

SUMMARY BACKGROUND: Development of postprandial abdominal discomfort, nausea, vomiting, or bezoar formation (Roux stasis syndrome) in the postoperative follow-up period has prompted questions about the role of Roux-en-Y gastrojejunostomy to treat or prevent bile reflux gastritis.
 

METHODS: Long-term clinical follow-up (mean, 11.9 years) data for 24 patients was collected by reviewing medical records, interviewing patients directly through telephone contact, or both. All patients who had symptoms in the follow-up period were evaluated by upper gastrointestinal series, endoscopy, or both. A modified Visick scale was used for clinical ratings.

RESULTS: Of the 22 evaluable patients, follow-up was complete in 20; the clinical condition that prompted surgery was corrected in 21 (95%). Roux-en-Y gastrojejunostomy was successful for treating or preventing bile reflux gastritis in all 22 patients. Despite this success, clinical failure (Visick scale III or IV) was documented in 8 patients (36%). Seven of the 8 patients had clinical failure within 6 months of operation, with the Roux stasis syndrome developing in 6 of them (27%).
 

CONCLUSION: This consecutive series of Roux-en-Y gastrojejunostomies performed by one surgeon has the longest follow-up to date. Although the Roux-en-Y gastrojejunostomy is safe and often successful, the procedure appears to be limited by a substantial rate of clinical dissatisfaction. Surgeons should be cautious in using it to treat primary or remedial gastrointestinal disease.
 

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