jejunojejunostomy

Jejunojejunostomy is a surgical anastomosis between two segments of the jejunum, performed to restore continuity of the small intestine after removal of a diseased segment or to create a bypass around a nonfunctional region. The procedure is commonly part of small bowel resection or reconstructive operations such as Roux-en-Y bypass.

Indications include obstruction, Crohn’s disease requiring resection, tumors, ischemia, or accidental injury to a segment of jejunum. It is also used in reconstructive surgeries after more extensive pancreatic or gastric procedures where jejunal continuity must be reestablished. The specific configuration of the anastomosis depends on the surgical goal and the surgeon’s preference.

Techniques vary but most reconstructions use either an end-to-end or a side-to-side anastomosis. The anastomosis can be created by hand-sewn sutures or by stapling devices. The procedure may be performed through an open approach or laparoscopically, and it may be part of a longer reconstructive sequence such as in Roux-en-Y anatomy. In some cases, a temporary diverting measure is used to protect the anastomosis.

Complications are primarily related to the anastomosis and include leakage, bleeding, infection, and anastomotic stenosis or obstruction. Other risks include intraabdominal abscess, fistula formation, and general postoperative ileus. Most patients recover with appropriate postoperative care, early detection of complications, and gradual dietary advancement.

Prognosis is generally favorable when performed for appropriate indications and in suitable patients, though outcomes depend on the underlying condition, bowel health, and presence of comorbidities.