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September 1959

Double Jejunal-Loop Replacement of Resected Stomach for Bilious Vomiting

Author Affiliations

Rochester, Minn.
Section of Surgery, Mayo Clinic and Mayo Foundation (Dr. Walters); Fellow in Surgery, Mayo Foundation (Dr. Nixon). The Mayo Foundation, Rochester, Minn., is a part of the Graduate School of the University of Minnesota.

AMA Arch Surg. 1959;79(3):479-482. doi:10.1001/archsurg.1959.04320090127018

The case we are presenting is that of a patient who, in 1955, underwent gastric resection of the Billroth II (Polya) type for a chronic, recurring, bleeding duodenal ulcer, symptoms of which she had had for 10 years. Three months after gastric resection and retrocolic antiperistaltic gastrojejunostomy she began having daily episodes of vomiting of bile. The episodes were so troublesome that in 1956 she underwent jejunojejunostomy. Little relief from the bilious vomiting followed, however; and substernal burning distress, probably due to esophagitis, developed.

The patient came to the Mayo Clinic in 1958, where it was decided to convert the Billroth II resection to a Billroth I type. We found, however, that the gastric resection had been so extensive that it would be impossible to approximate the remainder of the patient's stomach to the duodenum. For that reason the two loops making up the gastrojejunal anastomosis were cut across at

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