The nutritional consequences of gastric operations have been recently emphasized, and many4-6,9,15 consider them to be a most important factor in selecting an operation upon the upper gastrointestinal tract. The methods by which these nutritional deficits occur are thought to be related to (a) alterations in various functions of the stomach, (b) loss of absorptive surface of the duodenum and/or jejunum, and (c) interference with digestive processes in the stomach, duodenum, and jejunum.
The reconstruction following all gastric operations provides continuity directly (Billroth I principle) or by bypassing some portion of the proximal intestine (Billroth II principle). The former is said to be less likely to alter the nutritional status.4,13,16,22
This study is being presented to report the effect of various bypassing procedures involving the relative positions of the duodenum and the upper jejunum upon digestion and absorption in upper gastrointestinal reconstruction.
Preparations were made in dogs in
WINKLER JM, CAMPBELL DA. Location of Bile and Pancreatic Outlet in Upper Gastrointestinal ReconstructionImportance in Digestion and Absorption. AMA Arch Surg. 1960;80(5):768-773. doi:10.1001/archsurg.1960.01290220060009