The Roux-Y loop in modern digestive tract surgery.

The technique of Y loop was utilized by César Roux beginning in January 1892 for antral or pyloric obstruction. He used the proximal jejunum to perform a Y gastroenterostomy. However, he abandoned the procedure in 1911, having noticed the frequency of late peptic ulcerations in the loop. Nevertheless, the Y-branching idea was later reconsidered and applications in hepatic, biliary, and pancreatic surgery were developed, as well as applications in gastrointestinal surgery. In this latter area, Roux-Y anastomoses are now performed primarily or secondarily. Primary uses include restoring the continuity of the alimentary tract after total gastrectomy (with or without a pouch), reconstruction after Whipple's procedure, repair of duodenal trauma, and intentional digestive bypass for morbid obesity. Secondary uses include remedial procedures after simple esophagojejunostomy, gastric fundus resection, and a Billroth II procedure to obviate postoperative complications due to bile reflux.