Last updated: 11/24/2009

After removing a piece of the stomach, the surgeon reattaches the remainder to the rest of the bowel. The Billroth I gastroduodenostomy specifically joins the upper stomach back to the duodenum.

Typically, the procedure requires ligation (tying)...

of the right gastric veins and arteries as well as of the blood supply to the duodenum (pancreatico-duodenal vein and artery). The lumen of the duodenum and stomach is occluded at the proposed site of resection (removal). After resection of the diseased tissues, the stomach is closed in two layers, starting at the level of the lesser curvature, leaving an opening close to the diameter of the duodenum. The gastroduodenostomy is performed in a similar fashion as small intestinal end-to-end anastomosis, meaning an opening created between two normally separate spaces or organs. Alternatively, the Billroth I procedure may be performed with stapling equipment (ligation and thoraco-abdominal staplers).