TY - CHAP M1 - Book, Section TI - Gastrectomy, Hofmeister Method A1 - Ellison, E. Christopher A1 - Zollinger, Jr., Robert M. A1 - Pawlik, Timothy M. A1 - Vaccaro, Patrick S. A1 - Bitans, Marita A1 - Baker, Anthony S. PY - 2022 T2 - Zollinger’s Atlas of Surgical Operations, 11e AB - A schematic drawing shows the position of the viscera after this operation is completed, along with the alternative antecolic placement of the jejunal loop (FIGURE 1). In principle, this technique consists of closing about one-half of the gastric outlet adjacent to the lesser curvature and performing a gastrojejunal anastomosis adjacent to the greater curvature, with approximation of the jejunum to the entire end of the gastric remnant. Alternatively, a Roux-en-Y reconstruction should be considered in some cases to avoid the significant bile reflux that can occur with a small gastric pouch. This operation is favored when a very high resection is indicated because it provides a safer closure of the lesser curvature. It may also retard sudden overdistension of the jejunum after eating. The jejunum may be brought up either anterior to the colon or through an opening in the mesocolon to the left of the middle colic vessels (see FIGURE 2 in Chapter 31). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1187820908 ER -