A gastroenterostomy is a surgical connection between the stomach and small intestine. It is necessary if there are passage disorders in the gastrointestinal tract. A distinction is made between resecting and non-resecting gastroenterostomy procedures.
Here you will find further information and selected gastroenterostomy specialists and centers.
A gastroenterostomy is the creation of a surgical connection between the stomach and small intestine.
It is generally used in the case of passage disorders in the gastrointestinal tract. There are many indications for a gastroenterostomy.
A gastroenterostomy is generally used in two situations:
As a reconstruction of the gastrointestinal passage after resecting gastric surgery. These are operations in which part of the stomach has been removed. Resecting stomach operations are used, for example, to treat
As a bypass operation without gastric resection between the stomach and small intestine, for example
Doctors distinguish between two methods for resecting gastroenterostomies:
The surgeon resects 2/3 of the stomach, i.e. he cuts off two thirds of the stomach. The stomach stump is sutured to the duodenum. The original passage from the stomach to the duodenum remains intact (see figure f).
Types of gastroenterostomy
Here too, the surgeon resects 2/3 of the stomach. The duodenum is closed at its upper sedimentation point. The gastrointestinal passage can be restored using two methods:
The Schloffer gastroenterostomy (see figure c): A double jejunal loop (loop of small intestine) is pulled up to the stomach. This reconstruction requires the additional connection of the two legs of the raised loop at their base points. The digestive juices of the pancreas and bile can drain into the lower sections of the small intestine via this connection. This prevents reflux into the stomach.
Roux-Y reconstruction (see figure e): In a Roux-Y gastric bypass, the surgeon cuts through the upper small intestine (jejunum) about 40 cm after its transition from the duodenum. He connects the draining limb to the stomach as a gastroenterostomy. The digestive juices from the duodenum flow through the upper part of the severed loop of small intestine. This part is anastomosed laterally into the loop pulled up to the stomach.
A gastroenterostomy can be used to divert the passage of food if the natural passage is disturbed or blocked. This can be the case with inoperable tumors of the lower stomach or duodenum, for example.
The food passage is usually created by a side-to-side anastomosis. This involves an upper loop of small intestine being pulled up to the non-tumor-affected free part of the stomach and connected by a suture (see figures a and b).
A special form of gastroenterostomy in the sense of a bypass operation is used in bariatric surgery . Here there are various surgical techniques for reducing the size of the stomach or gastric bypass operations.
Normally, the chyme passes from the oesophagus into the stomach and then into the small intestine, where the components of the chyme are broken down © bilderzwerg | AdobeStock
The altered gastrointestinal passage can lead to varying degrees of rapid or delayed emptying of the stomach. A distinction is made between the following syndromes:
Dumping syndromes: These mainly occur with Billroth II resections. A distinction is made between early dumping and late dumping syndromes:
Loop syndromes: After a gastroenterostomy, the outflow of bile and pancreatic secretions is disturbed. This leads to a build-up of misdirected food residues and bacterial overgrowth. The consequences are
Doctors distinguish between two forms: Afferent loop and efferent loop. The cause lies in the lack of a connection between the two legs of the small intestine. The treatment is ultimately a conversion operation to a Billroth I or Billroth II Y-Roux stomach.
Other complications after gastric resection are
Patients should eat 6 to 12 small meals a day after the operation. Eat slowly and chew well. This allows the salivary enzymes in the mouth to participate in the digestive process.
In addition, vitamin B12 should be administered and a gastroscopy should be carried out to check this.
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