ROUX-EN-Y BILIARY DIVERSION - A WORTHWHILE PROCEDURE

The Roux-en-Y biliary diversion has varied in popularity, with poor re sults recently reported. A retrospective case note review was undertak en of all patients who underwent Roux-en-Y diversion, in a single cons ultant practice to assess a single clinicians results. Thirty-seven co nsecutive patients who underwent biliary diversion were studied: 22 ha d gastric malignancy and 15 had benign biliary reflux. The benign grou p revealed improvement in 80% with 40% being entirely asymptomatic and 66% being medication free. In the malignant disease group 15 patients were Visick grade I or II post-operatively; two were classified as Vi sick IV but one was converted to grade I after further gastric resecti on. The 30-day mortality in this group was 14 and 50% at 5 years. Good or satisfactory results can be obtained from Roux-en-Y biliary divers ion for patients with benign (80% satisfied) and malignant (84% satisf ied) disorders but care with patient selection in the benign group is required.