Comparative Endoscopic Evaluation of Reconstructive Roux-en-Y With Jejunal Loop Interposition Following Gastrectomy in Dogs

Objective- comparative endoscopic evaluation of two reconstructive methods (r&y andjejunal loop interposition) after gastrectomy in dogs.design- experimental study.animals- ten healthy male dogs.procedures- the animals were divided randomly in two groups. after a 12 hour food withhold and under general anesthesia laparotomy is performed in all dogs. in group a (r&y),after dissection and resection of all gastric vessels and ligaments the stomach was resectedcranially close to cardia and caudally close to pylorus. after gastrectomy duodenal end wasclosed in a two layer inverting suture pattern. then a loop of jejunum 20 cm distal to treitzligament was identified and resected. end to side anastomosis was performed between thedistal jejunal end and remained part of the stomach. the proximal jejunal end was end to sideanastomosed to the rest of jejunum. in group b (jli), gastrectomy was done in the samemanner. the 20 cm length of jejunum was resected from a 20 cm distance to treitz ligament.the proximal end of the jejunal loop was end to side anastomosed to the remained part of thestomach and the distal end was anastomosed to the proximal jejunum. finallyjejunojejunostomy was performed between the two jejunal parts. 1 month after surgery,esophagoscopic and gastroscopic evaluation was performed to rule out the reflux esophagitisor gastritis. results- esophagoscopy and gastroscopy thirty days after operation revealed normalappearance at gastrodeudenal and deudenojejunal anastomotic junctions. there was no reportof enterogastric biliary reflux (ebr) in esophagus or alkaline gastritis. a 2 cm to 2 cmulcerative mass was observed in the remained part of stomach close to gastrojejunalanastomotic site in one patient in group a. also regurgitation was noticed in the same patient.a 1 cm to 1 cm ulcer was reported in one patient in group b. morphology of all anastomoticsites was normal. they were all patent and healed normally without any signs ofinflammation.conclusion and clinical relevance- the results of this study showed that the jli like r&ytechnique is a successful method to prevent reflux esophagitis.