RT Book, Section A1 Ellison, E. Christopher A1 Zollinger, Jr., Robert M. A1 Pawlik, Timothy M. A1 Vaccaro, Patrick S. A1 Bitans, Marita A1 Baker, Anthony S. SR Print(0) ID 1187820817 T1 Hemigastrectomy, Billroth I Method T2 Zollinger’s Atlas of Surgical Operations, 11e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781260440850 LK accesssurgery.mhmedical.com/content.aspx?aid=1187820817 RD 2024/03/28 AB The Billroth I procedure for gastroduodenostomy is the most physiologic type of gastric resection because it restores normal continuity. Although long preferred by some surgeons in the treatment of gastric ulcer or antral carcinoma, its use for duodenal ulcer has been less popular. Control of acid secretion by vagotomy and antrectomy has permitted retention of approximately 50% of the stomach while ensuring the lowest ulcer recurrence rate of all procedures (FIGURE 1). This allows an easy anastomosis without tension, provided that both stomach and duodenum have been thoroughly mobilized. Furthermore, a poorly nourished patient has an adequate gastric capacity for maintaining a proper nutritional status postoperatively. Purposeful constriction of the gastric outlet to the size of the pylorus tends to delay gastric emptying and decrease postgastrectomy complaints.