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Subtotal gastrectomy Graphic

Advantages of PPH and Points for Attention

How to use linear Stapler or circular stapler in gastric surgery?


Surgical Stapler Development


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Subtotal gastrectomy Graphic

Billroth antrectomy: the gastric and duodenal directly anastomose, usually used for patients with gastric ulcer.
Its advantages are:
1. a simple, consistent with the physical;

2. to reduce or avoid bile, pancreatic juice into the anti-gastric, thereby reducing the residual gastritis, gastric remnant from happening.

3. CCK-secreting cells are mainly located in the duodenum, Billroth after-match food through the duodenum, can be effective in stimulating cells cholecystokinin, reducing post-operative cholecystitis, gallstones Morbidity.

The ulcer penetrating the pancreas, and other organs conglutination, it is not suitable for Billroth antrectomy. To be completely removed ulcers, it has injury risk of pancreas or bile duct, such as the removal of inadequate anastomotic tension, and e-ulcer recurrence after operation.

Billroth Gastro-jejunostomy: Gastric will coincide with the proximal jejunum, the stump of duodenum closure.




1. you can remove enough size of the stomach without worrying about anastomosis tension, a low incidence of the match ulcers after operation.


2. on the difficult removal of duodenal ulcer, the possible exclusion is Bancroft ulcer surgery.


The biggest weaknesses of the operation are the various after-effects. Bile, pancreatic juice gastrojejunostomy must pass through the mouth, and cause alkali reflux gastritis.

Stomach jejunum Roux-en-Y anastomosis: cut off the jejunum 0-15cm away from Treitz ligament, and match the remote jejunum with gastric before or after colon, about 50cm under Anastomotic, end-to-side distal jejunum or side-to-side anastomosis.


The method has the advantage of better prevention of bile, pancreatic juice reflux. The smaller the angle between the jejunum, the better the effect of anti-reflux. The distance between two anastomosis should be about 50cm. If it is too short, the effect of the anti-reflux will be not poor.


Surgical operation is more complicated, the main drawback is that if not cut off the vagus nerve at the same time, it is easily led to anastomotic ulcer.











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