J Pediatr Surg 1990 Mar;25(3):311-4

Intussusception-type antireflux valve in the Roux-en-Y loop to prevent ascendin
cholangitis after hepatic portojejunostomy

Nakajo T, Hashizume K, Saeki M, Tsuchida Y
Department of Pediatric Surgery, University of Tokyo, Japan.

Abstract
An intussusception-type antireflux valve was created in the Roux-en-Y loop in 23
infants with biliary atresia (17 new cases, and six others after episodes of
ascending cholangitis) and 10 patients with congenital bile duct dilatation, in
order to prevent ascending cholangitis after hepatic portojejunostomy.
Mesenteric blood vessels were divided in a 4 cm length of the Roux-en-Y loop,
and the distal 1.5 cm of this portion was further denuded of the seromuscular
layer; an antireflux valve was thus established by invaginating the proximal
portion into the denuded jejunum. No case, in which this technique was used, was
associated with any surgical complications, and ascending cholangitis never
developed in any of the 17 new cases with biliary atresia, during an average
follow-up of 32 months