In general surgery, a Roux-en-Y anastomosis, less formally and precisely Roux-en-Y, is a surgically created (end-to-side) anastomosis. Typically, it is between small bowel and small bowel that is distal (or further down the gastrointestinal tract) from the cut end.

The name is derived from the surgeon that first described it (César Roux) and the stick-figure representation. Diagramatically, the Roux-en-Y anastomosis looks like the letter Y; typically, the two upper limbs of the Y represent a proximal segment of small bowel and the distal small bowel it joins with (which is often a blind end), and the lower part of the Y the distal small bowel (beyond the anastomosis).

Roux-en-Ys are used in several operations and collectively called Roux operations.

Schematic of gastric bypass using a Roux-en-Y anastomosis. The transverse colon is removed to clearly show the Roux-en-Y.

Schematic of gastric bypass using a Roux-en-Y anastomosis. The transverse colon is removed to clearly show the Roux-en-Y.

• Some gastric bypasses for obesity.
• Roux-en-Y reconstruction following partial or complete gastrectomy for stomach cancer.
• Roux-en-Y hepaticojejunostomy used to treat (macroscopic) bile duct obstruction which may arise due to:
  • a common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma)
  • a bile duct injury (e.g. cholecystectomy surgical misadventure, trauma)
  • an infection/inflammation (e.g. pancreatic pseudocyst)
• Roux-en-Y choledochojejunostomy - indications same as Roux-en-Y hepaticojejunostomy.

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