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June 1948

ANATOMIC MECHANICS UNDERLYING GASTROJEJUNOSTOMY: With Particular Reference to Anterior or Antecolic Types of Anastomoses

Author Affiliations

From the Departments of Surgery of the Cook County Hospital, Cook County Graduate School of Medicine and the Wesley Memorial Hospital, Chicago.

Arch Surg. 1948;56(6):709-717. doi:10.1001/archsurg.1948.01240010720002

THERE is a common belief that an anterior or antecolic anastomosis between stomach and jejunum has advantages over a posterior or retrocolic type of union. This belief is held for the simple gastroenterostomy of the Wölfler type as well as for the anastomoses that are done following resection of the stomach. It is not the purpose of this paper to offer a partisan view of the merits of either the antecolic or retrocolic procedure. It is assumed that both operations have their individual advantages, under varying conditions. There is a need for better appreciation of some of the mechanical and anatomic limitations which present themselves to the surgeon who does either operation.

The suggestion is made that when the omentum is thick and the mesentery of the transverse colon is fatty, one can bring a long loop of the jejunum around the colon easier and more safely than can be

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