Peritoneolysis in the Reconstruction of a Roux-en-Y Loop

Abstract

The Roux-en-Y loop has been used extensively following resection of the proximal part of the biliary tract or in a proximal esophagogastrectomy, performed because of a primary adenocarcinoma in this area or a soft tissue sarcoma involving these structures. It is also used as a bypass to restore the flow of bile into the gastrointestinal tract if the tumor itself is not resectable, or to drain pancreatic secretions into the GI tract. Sometimes the Roux-en-Y will not reach the desired level without tension. Passing the Roux-en-Y loop through an opening in the transverse mesocolon provides the shortest route to reach the proximal hepatic duct or the esophagus.