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Abstract
Roux-en-Y gastrojejunostomy is effective in preventing alkaline reflux into the gastric remnant. A substantial number of patients with a Roux-en-Y diversion complain about abdominal pain, epigastric fullness, nausea, and vomiting, worsened by eating. Clinical and experimental studies have shown that gastroparesis of the gastric remnant and motility disturbances of the Roux limb probably both have a role in the pathogenesis of this so-called Roux-en-Y syndrome. Vagal denervation due to truncal vagotomy is thought to worsen the abnormal motoric function. In a study in 21 patients we observed slow gastric emptying in symptomatic patients without vagal function. Slight manometric abnormalities and stasis of food in the Roux limb were observed in several patients, without, however, a clear correlation with symptoms. Except for near total gastrectomy in selected patients effective treatment is not yet available for these patients, several of whom are severely disabled by their symptoms.