Billroth ii procedure

(Christian Albert Theodor Billroth, 1829 - 1894, German surgeon), subtotal gastrectomy and gastroenterostomy linking the gastric pouch to the jejunum distal to the ligament of Treitz. A loop-type gastrojejunostomy connects the jejunum to the stomach in one continuous segment. The configuration can be a right to left or antiperistaltic loop (Fig.1) in which the afferent, or that part of the bowel bringing bile and bowel contents toward the stomach, is first anastomosed to the right or lesser curvature portion of the stomach and is then carried across to the left side. The anastomosis can also be constructed so that the jejunum is connected from the left to the right side of the stomach and the direction of peristalsis in the stomach and in the attached jejunum are the same (isoperistaltic loop) (Fig.2). The Roux- and Y-anastomosis is a procedure in which the jejunum is cut and the proximal end is anastomosed to the stomach while the distal end is used for an enterostomy downstream.

ALB