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In general surgery, a Roux-en-Y anastomosis, or Roux-en-Y, is an end-to-side surgical anastomosis of bowel used to reconstruct the gastrointestinal tract. Typically, it is between stomach and small bowel that is distal (or further down the gastrointestinal tract ) from the cut end.
The Roux limb is constructed using 80–150 cm (31–59 in) of the small intestine, preserving the rest (and the majority) of it from absorbing nutrients. The patient will experience a very rapid onset of the stomach feeling full, followed by a growing satiety (or "indifference" to food) shortly after the start of a meal.
The afferent loop is made up of a segment of duodenum and/or proximal jejunum located upstream of a double-barrel gastrojejunostomy anastomosis. Abdominal pain and distension are signs of increased intraluminal pressure resulting from the accumulation of enteric secretions in the obstructed afferent loop. [2]
The epithelial cells which line these villi have microvilli. The transport of nutrients across epithelial cells through the jejunum and ileum includes the passive transport of sugar fructose and the active transport of amino acids, small peptides, vitamins, and most glucose. The villi in the jejunum are much longer than in the duodenum or ileum.
The surgery involves exposing the porta hepatis (the area of the liver from which bile should drain) by radical excision of all bile duct tissue up to the liver capsule and attaching a Roux-en-Y loop of jejunum to the exposed liver capsule above the bifurcation of the portal vein creating a portoenterostomy. [1]
A desmotubule is an endomembrane derived structure of the plasmodesmata that connects the endoplasmic reticulum of two adjacent plant cells. [ 1 ] [ 2 ] The desmotubule is not actually a tubule but a compact, cylindrical segment of the ER that is found within the larger tubule structure of the plasmodesmata pore. [ 3 ]
Jejunoileal bypass (JIB) was a surgical weight-loss procedure performed for the relief of morbid obesity from the 1950s through the 1970s in which all but 30 cm (12 in) to 45 cm (18 in) of the small bowel were detached and set to the side.
Malignant cell growth, such as a pancreatic head tumor, [3] can prevent proper repositioning of the duodenum to be in close contact with the bile duct. [5] Performing a CDD may lead to a tension-filled surgical anastomosis, leading to bile leakage and jaundice. [6] There is also the possibility of active tumour growth obstructing the CBD.