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Billroth II Procedure

The Billroth II procedure involves a subtotal gastrectomy and connecting the gastric pouch directly to the jejunum below the ligament of Treitz. The connection can be made with either an antiperistaltic or isoperistaltic loop. The Roux-en-Y procedure involves cutting the jejunum and connecting the proximal end to the stomach and the distal end downstream to form an enterostomy.

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Jasmin Miranda
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198 views

Billroth II Procedure

The Billroth II procedure involves a subtotal gastrectomy and connecting the gastric pouch directly to the jejunum below the ligament of Treitz. The connection can be made with either an antiperistaltic or isoperistaltic loop. The Roux-en-Y procedure involves cutting the jejunum and connecting the proximal end to the stomach and the distal end downstream to form an enterostomy.

Uploaded by

Jasmin Miranda
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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Billroth ii procedure

(Christian Albert Theodor Billroth, 1829 - 1894, German surgeon), subtotal gastrectomy and
gastroenterostomy linking the gastric pouch to the jejunum distal to the ligament of Treitz. A
loop-type gastrojejunostomy connects the jejunum to the stomach in one continuous segment.
The configuration can be a right to left or antiperistaltic loop in which the afferent, or that part of
the bowel bringing bile and bowel contents toward the stomach, is first anastomosed to the right
or lesser curvature portion of the stomach and is then carried across to the left side. The
anastomosis can also be constructed so that the jejunum is connected from the left to the right
side of the stomach and the direction of peristalsis in the stomach and in the attached jejunum are
the same (isoperistaltic loop) The Roux- and Y-anastomosis is a procedure in which the jejunum
is cut and the proximal end is anastomosed to the stomach while the distal end is used for an
enterostomy downstream.

Arrival at the Hospital or Surgical Center

If surgery is being done on an outpatient basis, the patient must arrange for someone to be with
them upon discharge. Even though the anesthesia has worn off, grogginess can last several hours
and it is unsafe to drive. Also, the patient may need assistance when they get home.

If surgery is being done on an inpatient basis, the patient checks into a room. Most patients
return to their room after surgery, but those undergoing complex surgical procedures and those
who have complications may go to the intensive care unit (ICU). Outpatients usually go to an
area designated for same day surgery.

After arrival, time is needed to prepare the patient for the procedure and sometimes, the time of
surgery is changed due to cancellations or emergencies.

All patients must sign an informed consent form acknowledging that they are aware of risks
and complications, that they know they will be receiving anesthesia, and that the surgeon has
explained the operation to them. The surgery will not proceed unless the consent form is signed.

Patients are usually asked to remove personal items (e.g., jewelry, eyeglasses, hairpieces,
contact lenses, dentures) before surgery. This policy protects the patient and prevents the items
from being lost or damaged. Depending on the procedure, eyeglasses or hearing aids may be
worn.

Different staff members may ask the same questions. The clerk who checks the patient in asks
several questions, as does the admitting nurse and the anesthesiologist. These questions may be
the same or similar and this may seem tedious, but the information must be checked and double-
checked to avoid errors and omissions.
Before Surgery

The doctor who administers the anesthesia (anesthesiologist) performs a brief physical
examination; takes a patient history; and obtains information regarding medication used on a
regular basis, drug allergies, and prior adverse reactions to anesthesia. This information helps the
anesthesiologist select the most suitable anesthetic agents and dosages to avoid complications.

Patients are usually taken to a preoperative or holding area before surgery. An intravenous line
(IV) is started here if the patient does not already have one. A sedative may be given by
injection, through the IV, or occasionally, orally, to help the patient relax.

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