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Laparoscopic distal gastrectomy with Billroth II reconstruction for peptic ulcer obstruction

HK Yang, MD, PhD, FACS
Epublication WebSurg.com, Jan 2015;15(01). URL: http://websurg.com/doi/vd01en4131

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  • 2015-01-15
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This live surgery video demonstrates a laparoscopic distal gastrectomy with Billroth II reconstruction in a patient with pyloric stenosis which was caused by peptic ulcer. Treatment using balloon dilatation failed. The fibrotic area of the duodenal ulcer was approached by fine dissection and ligation of right gastro-epiploic and right gastric vessels. The dissection was performed around the duodenum until an adequate margin could be obtained in the healthy portion of the distal duodenum. The duodenum was then transected by means of a stapler. A relatively large dilated stomach including the antrum and part of the gastric body was transected, and a Billroth II gastrojejunostomy was performed.