OUTCOME OF REVISIONAL GASTRIC-SURGERY USING A ROUX-EN-Y BILIARY DIVERSION

One hundred and seven patients with postoperative reflux gastritis treated by Roux‐en‐ Y biliary diversion were reviewed. Three patients died in the postoperative period, and 16 others have since died; cardiorespiratory disease was the most frequent cause of death. Seventy‐nine patients were interviewed at a median of 5·5 years (range 0·5–26 years) following Roux‐en‐Y diversion. At review, a satisfactory result by modified Visick grading was present in 47 per cent of patients. Bilious vomiting (P<0·001), food vomiting (P<0·01), the severity of upper abdominal pain (P<0·001) and heartburn (P<0·025) were significantly improved by Roux‐en‐ Y diversion. Weight, haemoglobin levels and employment status were not significantly altered by the procedure. Outcome was related to the surgery preceding Roux‐en‐ Y diversion with significantly better results after partial gastrectomy compared with truncal vagotomy and drainage (P<0·01), cholecys‐tectomy (P<0·05), or combinations of these procedures (P<0·01). Outcome was not predicted by sex, preoperative symptoms, smoking status, consultant surgeon, length of Roux‐en‐Y or 99Tc‐Sn‐2,6‐di‐ethylacetanilidoiminodiacetate (HIDA) scanning results. Copyright © 1990 British Journal of Surgery Society Ltd.