Surgical Management: Billroth II
When partial gastrectomy is performed, there are several options available for reconstruction including Billroth I (BI), Billroth II (BII), and Roux-en-Y (REY). While utilized less frequently than the others, the BII is indicated in specific circumstances such as the multiply operated abdomen, anticipated need for biliary tree access, and avoidance of complications specifically associated with the alternative operations. Postoperatively, morbidities associated with this procedure include nutritional deficiencies, dumping syndromes, afferent loop syndrome, delayed gastric emptying, bile reflux, and ulcers. Familiarity with the BII is critical for the management of patients who have undergone this procedure in the past as well as keeping it in the armamentarium of surgical options should it become necessary intraoperatively.
KeywordsBillroth II Gastrojejunostomy Partial gastrectomy BII
- 1.Bumm R, Siewert JR. Distal gastrectomy with Billroth I or Billroth II reconstruction. Mastery of surgery. 6th ed; p. 986–95. Philadelphia: Wolters Kluwer, 2011.Google Scholar
- 5.Yang H, Kong S, Hope W, Kercher K, Heniford BT. Laparoscopic resection for gastric adenocarcinoma. Mastery of endoscopic and laparoscopic surgery. 4th ed; p. 235–55. Philadelphia: Lippincott Williams and Wilkins, 2014.Google Scholar
- 6.Radigan AE. Post-gastrectomy: managing the nutrition fall-out. Practical gastroenterology, Nutrition issues in gastroenterology, series #18; p. 63–75. New York: Mahl, 2004.Google Scholar
- 7.Kate V, Kalayarasan R, Elamurugan TP, Ananthakrishnan N. Surgery for peptic ulcer disease. Textbook of surgical gastroenterology. p. 283–99. New Delhi: Jaypee Brothers Medical Publishers, 2016.Google Scholar