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Article
February 1942

RECONSTRUCTION OF THE STOMACH OUTLET IN GASTRIC RESECTIONA SIMPLE SUTURE FOR USE WITH THE BILLROTH 2 ORALIS TOTALIS TYPE OF OPERATION

Author Affiliations

PHILADELPHIA
From the Lankenau Hospital, service of Dr. George P. Müller.

Arch Surg. 1942;44(2):378-382. doi:10.1001/archsurg.1942.01210200194014
Abstract

The most popular procedure for anastomosing the stomach with the jejunum in the Billroth 2 type of gastric resection is the end to side anastomosis (terminolateral gastrojejunostomy), i.e., the Billroth 2 oralis totalis type. The operation has one disadvantage; the wide stomach outlet, consisting of the entire transverse section of the stomach, permits rapid emptying of the stomach and consequently considerable shortening of the second or gastric phase of digestion. Several methods have been suggested for narrowing the width of the anastomosis. Usually, the proximal half of the divided stomach is closed while the distal part is left open to be anastomosed with the jejunum (Billroth 2 oralis inferior), or the distal part is closed and the proximal half anastomosed (Billroth 2 oralis superior). This method leaves one weak point, and that is the meeting of the closed part and the anastomosis—the three corner point. Billroth aptly called this point

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