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 1187820908
T1 Gastrectomy, Hofmeister 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=1187820908
RD 2024/04/24
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).