IN RECENT years the Roux-Y operation has been used with increasing frequency in the treatment of common duct strictures,4 pancreatitis,3 pancreatic cysts,* and other lesions of the common duct8 requiring anastomosis of the biliary tree to the gastrointestinal tract (Figs. 1 and 2). Although the immediate postoperative results in many of the reported cases seem satisfactory, it might be well, before accepting this operation for general use, to consider its theoretical shortcomings. The operation in effect produces a modified Mann-Williamson preparation, in which the bile (strictures) or pancreatic secretions (pancreatic cysts) are shunted to a lower level in the gastrointestinal tract.
Dragstedt† has convincingly confirmed the view that total deviation of the alkaline juices of the duodenum into the lower gastrointestinal tract results in a high incidence of gastrojejunal ulcer formation. This is due, in part, to the decrease in the neutralizing and buffering action of pancreatic
BLEGEN HM. ROUX-Y OPERATION VS. PARTIAL GASTRECTOMY: Further Consideration of Treatment of Lesions of Common Duct and Pancreas: Review of Five Cases. AMA Arch Surg. 1955;70(2):298–302. doi:10.1001/archsurg.1955.01270080144024
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