Peritoneolysis in the reconstruction of the Roux-en-Y loop.

A technique to provide an additional 5 centimeters of length, without compromising the blood supply to the anastomosis, was developed. It has been applied to 26 patients, 18 with Roux-en-Y biliary bypass at various levels, five with high Roux-en-Y esophagojejunostomies and three with gastrojejunostomies. In the last three patients with unresectable adenocarcinoma of the distal part of the stomach and invasion of the intestinal mesentery, due to foreshortening of the latter, the proximal loop of the intestine would not reach the desired level of the stomach until this maneuver was performed.