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Hepatogastroenterology 58 14131424 2011. 89 P 0001 and similar gastric residue 226 vs.
The Billroth I BI operation is a gastroduodenostomy that can be performed end-to-end or end-to-side.
Billroth i vs ii. Billroth II method of anastomosis was associated with higher rate of early postoperative complications. Therefore we conclude that the Billroth I method should be the first choice after a distal gastrectomy as long as the anatomic and oncological environment of an. Billroth II gastro-jejunostomy method was not supported by the results of these tests 20-26.
In our clinical practice we observed that postoperative complications were higher in the Billroth II type of anastomosis therefore we compared the early postoperative complications of patients with the Billroth I and Billroth II type of anastomosis. In our previously reported long-term follow-up study of the Billroth I operation for peptic ulcer 185 patients 139 men and 46 women were followed for 6 to 10 years. We shall contrast the results in the Billroth I series with the results in the Billroth II series reported in this paper.
A Billroth I is the creation of an anastomosis between the duodenum and the gastric remnant gastroduodenostomy. A Billroth II operation is constructed by sewing a loop of jejunum to the gastric remnant gastrojejunostomy. Billroth I is loosely used to refer to any partial gastric resection with an anastomosis to the duodenal stump.
Billroth II loosely refers to any partial gastric resection with a gastrojejunostomy. The duodenal bulb is closed off and becomes part of the afferent limb. However there is no significant difference between Billroth I and Billroth II in terms of patients recovery and post-operative complications.
Two years postoperatively the RY group tended to have more gastric residue 242 vs. 133 P 0020 and less bile reflux 0 vs. 60 P 0001 than the B-I group.
Five years postoperatively compared with the B-I group the RY group tended to have less gastritis 78 vs. 223 P 0003 less bile reflux 04 vs. 89 P 0001 and similar gastric residue 226 vs.
The operation time of patients in Billroth I group Billroth II group and RY group was 20914 628 min 21003 619 min and 21098 630 min respectively. The differences in operation time between the Billroth I and RY groups and the Billroth II and RY. Billroth procedures remove the lower portion of the stomach as well as the beginning of the intestine called the duodenum.
A Billroth 1 procedure is when the remaining part of the stomach is. The Billroth I BI operation is a gastroduodenostomy that can be performed end-to-end or end-to-side. In the Billroth II BII reconstruction the gastrojejunostomy is performed end-to-side.
As an alternative Roux-Y RY reconstructions can be done see Chapter 82. A decisive difference between the BI and BII procedure is that in BI reconstruction the duodenal passage remains intact. Comparative Study of Antiperistaltic vs Isoperistaltic Billroth II Braun Anastomosis for Postoperative Reflux.
The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean. There was no significant difference of malignancy status between Billroth I and Billroth II group p 0316.
But the complication rate was significantly higher in Billroth II than Billroth I group even after controlling the malignancy status p 0001. BACKGROUNDAIMS After a distal resection of the stomach the continuity of the gastrointestinal tract can be restored by either a gastroduodenal anastomosis Billroth I a gastrojejunal anastomosis Billroth II or a Roux-en-Y gastrojejunostomy. There is still no consensus on the reconstruction technique of choice.
Billroth I reconstruction consists of a gastroduodenostomy in which the anastomosis is created between the gastric remnant and the duodenum Fig. Billroth II reconstruction consists of a gastrojejunostomy in which a side-to-side anastomosis is created between the gastric remnant and a loop of jejunum with closure of the duodenal stump Fig. Billroth I vs Roux-en-Y reconstruction has been extensively studied with a prospective series by Sounya Nunobe et al that reported superior symptomatic and functional outcomes of Roux-en-Y procedure 2.
However a randomised trial by Makoto Ishikawa et al found limited advantages of Roux-en-Y over Billroth I reconstruction 3. In the Billroth I BI procedure the surgeon removes the pylorus and connects the remaining portion of the stomach with the duodenum. In 1885 Billroth I was modified to Billroth II BII when Billroth and von Hacker joined the remaining stomach to the jejunum in a side-to-side mannergastrojejunostomy.
Roux-en-Y following distal gastrectomy. A meta-analysis based on 15 studies. Hepatogastroenterology 58 14131424 2011.
Billroth II more formally Billroths operation II is an operation in which a partial gastrectomy removal of the stomach is performed and the cut end of the stomach is closed. The greater curvature of the stomach not involved with the previous closure of the stomach is then connected to the first part of the jejunum in end-to-side anastomosis. 32 Operative and pathological outcomes.
The operative and pathological findings are shown in Table 2On comparing the B-I and R-Y groups the operation time was significantly longer in the R-Y group than in the B-I group 1889 vs 2383 minutes respectively. P 0001 and the intraoperative estimated blood loss was larger in the R-Y group than in the B-I group 1031 vs 1295 g. I dont reserve any rights on this video.
This video was made by Oncolex. About Press Copyright Contact us Creators Advertise Developers Terms Privacy Policy Safety How YouTube works Test new features Press Copyright Contact us Creators. The key feature of a Billroth I reconstruction is the formation of an end-to-end anastomosis between the proximal remnant stomach and duodenal stump.
Alternative reconstruction techniques includes a Billroth II reconstruction an end-to-side anastomosis between the stomach and jejunum as well as a Roux-en-Y gastric bypass. A Billroth I reconstruction can be converted to a Roux-en-Y bypass. Billroth-I is also more physiological because it maintains the normal passage of food into the duodenum.
Billroth II and Roux-en-Y reconstructions are the 2 most commonly used techniques when Billroth I reconstruction is not applicable after distal gastrectomy. As far as we know Billroth II reconstruction is often used because of its simplicity. The arterial blood supply to the stomach is rich and comes from multiple sources.
These include the left gastric artery branch of the celiac axis right gastric artery branch of the hepatic artery and right and left gastroepiploic arteries which form an arcade along the greater curvature and short gastric arteries from the superior pole of the spleen that.