Question 10#

Which of the following options is the least preferable reconstruction for patients undergoing antrectomy for PUD?

a. Billroth I
b. Billroth II
c. Roux-en-Y gastrojejunostomy
d. All are equally preferable

Correct Answer is C


Following antrectomy, GI continuity may be reestablished with a Billroth I gastroduodenostomy or a Billroth II loop gastrojejunostomy. Since antrectomy routinely leaves a 60 to 70% gastric remnant, routine reconstruction as a Roux-en-Y gastrojejunostomy should be avoided. Although the Roux-en-Y operation is an excellent procedure for keeping duodenal contents out of the stomach and esophagus, in the presence of a large gastric remnant, this reconstruction will predispose to marginal ulceration and/or gastric stasis.