TY - CHAP M1 - Book, Section TI - Hemigastrectomy, Billroth II Stapled A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. Y1 - 2022 N1 - T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - The Billroth II gastric resection is one of the most commonly performed procedures for malignancy of the stomach or for the control of gastric hypersecretion in the treatment of ulcer. The extent of the resection varies, with a two-thirds to three-fourths resection being the most common. When the left gastric vessels are ligated, 75% or more of the stomach is resected, with the major blood supply coming from the gastrosplenic circulation. In the presence of carcinoma involving the body of the stomach, all the lymph nodes along the lesser curvature up to the esophagus are resected. The greater omentum is also removed, along with any lymph nodes about the right gastroepiploic vessels. When a malignancy is near the pylorus, 2–3 cm at least of the duodenum distal to the pylorus should be resected. Sometimes only a rim of gastric mucosa remains attached to the esophagus, which may require reconstruction with sutures rather than with the stapler. Consideration should be made for laparoscopic resection in patients without a contraindication such as extensive previous operations or large, bulky tumors. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187820930 ER -