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Complications - Gastrointestinal anastomosis technique – Roux-en-Y esophagojejunostomy

general and visceral surgery
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Anatomy Perioperative management Technique Complications Evidence Total Video

  1. Intraoperative complications

    • In extreme cases the esophagus may slip craniad and can no longer be clamped. In this case the hiatus must be enlarged. In extreme cases, this mandates right thoracotomy for the anastomosis to be fashioned. If this happens in a hospital not equipped to perform such a thoracotomy, drain the region and transfer the patient to the nearest thoracic surgery center.

  2. Postoperative complications

    • Failure of the esophagojejunostomy
      This can be verified by endoscopy or upper GI series with diatrizoic acid (Gastrografin®). If the anastomosis is still well drained, watchful waiting often suffices. Otherwise, this requires revision surgery with de novoesophagojejunostomy. In individual cases, endoscopic procedures such as fibrin sealing may be effective.
    • Failure of the afferent limb (jejunojejunostomy)
      Here, a new anastomosis should be fashioned, which in most cases is technically quite feasible.