Surgical treatment of Roux stasis syndrome

Abstract

We wondered whether the slow gastric emptying of the Roux stasis syndrome could be improved by performing a corrective “uncut” Roux operation. Five dogs had a standard Roux gastrectomy and placement of serosal electrodes on the proximal jejunum and Roux limb. After recovery, baseline myoelectrical and gastric emptying data were collected. The animals then underwent a second operation: take down of the Roux limb, restoration of jejunal continuity, and construction of an “uncut” Roux limb. After the animals recovered, the tests were repeated. The slow frequency of pacesetter potentials (PPs) in the standard Roux limb (mean ± standard error of the mean 14 ± 0.4 cpm) was unchanged after the uncut Roux operation (14 ± 0.5 cpm, P >0.05). However, a greater percentage of PPs propagated aborally in the uncut Roux limb (81% ± 4%) than in the standard Roux limb (53% ± 7%, P <0.05). Nonetheless, gastric emptying of a 250 ml 10% dextrose liquid meal was not speeded by the uncut Roux operation (uncut Roux = 36% ± 5% emptied by 20 minutes vs. standard Roux = 35% ± 7%; P >0.05). Bile acid concentrations in gastric aspirates were minimal after both operations (0.7 ± 0.2 μmol/L vs. 0.6 ± 0.1 μmol/L; P >0.05). The conclusion was that more PPs propagated in the aborad direction in the uncut Roux limb than in the standard Roux limb, but gastric emptying was not speeded by the uncut Roux operation. Both operations were equally effective in preventing bile reflux into the gastric remnant.