Electromyographic evaluation of the gastrointestinal tract in patients with chronic Roux-en-Y limb.

Recently, a Roux-en-Y stasis syndrome was described in a few patients after gastric operations. Although the clinical long term results are usually good, the motility of Roux-en-Y biliary limb has not been evaluated yet. In the present study, we report electromyographic studies of the gastrointestinal tract of two patients with chronic Roux-en-Y hepaticojejunostomy. These two patients provided a unique opportunity to evaluate the electromyographic activity of chronic Roux-en-Y limb in humans after one to five years. Seven pairs of bipolar extracellular electrodes were implanted in the antrum, duodenum, proximal part of the jejunum (15 centimeters proximal to the jejunojejunostomy), distal part of the jejunum (15 centimeters distal to the jejunojejunostomy), ileum, proximal Roux-en-Y limb and distal Roux-en-Y limb. All four phases of the migrating motor complex (MMC) were identified in the antrum and small intestine, including the Roux-en-Y limb, almost simultaneously to phase III in the duodenum. In the other two recordings (25 per cent), there was no relationship between phase III in the Roux-en-Y limb and that in the duodenum. Ingestion of food caused substitution of the MMC by the fed activity pattern in all recordings in the antrum and small intestine, including the Roux-en-Y limb. The findings of the present study indicate that the electromyographic activity of the Roux-en-Y limb may remain normal during fasting and fed states even many years after its creation.