Billroth I
Billroth I is a type of surgical reconstruction that has been performed after partial gastrectomy, usually in the setting of tumor or ulcer resection.
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 if required.
A Billroth I procedure is favored for early gastric cancer in Japan and Korea, largely because of the physiological advantage of allowing food to pass directly through the stomach to the duodenum. While not inferior to a Roux-en-Y bypass it is associated with less effective prevention of reflux esophagitis and gastritis.
Complications
- alkaline reflux esophagitis (reflux of biliary contents retrograde into the stomach causing alkaline gastritis)
- dumping syndrome
History and etymology
Although named after Therodor Billroth, an Austrian surgeon who first completed the operation in 1881, it was first described and performed by Professor Ludwik Rydygier in 1880, and it has also been known as "Rydygier's resection."
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