Billroth Surgery

 Definition

Billroth Surgery is a partial resection of the stomach with anastomosis to the duodenum (Billroth I) or to the jejunum (Billroth II). It is a standard treatment for ulcer disease, stomach cancer, injury and other diseases of the stomach. This was first described by Theodor Billroth, the pioneer in modern surgery.

Billroth I & Billroth II

Billroth I is also called gastroduodenostomy. It involves the partial gastrectomy or removal of the antrum and pylorus of stomach) with anastomosis of the gastric stump to the duodenum.
Billroth II is also called gastrojejunostomy. It involves the partial gastrectomy or removal of the antrum and pylorus of stomach) with anastomosis of the gastric stump to the jejunum.

Procedure

1. After removing a piece of the stomach, the surgeon reattaches the remainder to the rest of the bowel
2. Billroth I gastroduodenostomy specifically joins the upper stomach back to the duodenum while Billroth II joins it to the jejunum

Preparation

1. Thorough Medical History Taking and assessment
2. Intravenous or intramuscular administration of antibiotics
3. Insertion of intravenous lines for administration of electrolytes and supply of compatible blood

Nursing Consideration (Postoperative)

1. Monitor Vital Signs Accurately
2. Monitor Operative Site and assess for any signs of infection
3. Administer pain Medication as indicated or as ordered

Possible Side Effects

1. Duodenogastric reflux, resulting in persistent vomiting
2. Dumping syndrome, occurring after a meal and characterized by sweating, abdominal pain, vomiting, lightheadedness, and diarrhea
3. Low blood sugar levels (hypoglycemia) after a meal
4. Malabsorption of necessary nutrients, especially iron, in patients who have had all or part of the stomach removed