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The duodenal switch (DS) procedure, also known as a gastric reduction duodenal switch (GRDS), is a weight loss surgery procedure that is composed of a restrictive and a malabsorptive aspect. The restrictive portion of the surgery involves removing approximately 70% of the stomach (along the greater curvature) and most of the duodenum .
For severe duodenal ulcers, it may be necessary to remove the lower portion of the stomach and the upper portion of the small intestine. If there is a sufficient portion of the upper duodenum remaining, a Billroth I procedure is performed, where the remaining portion of the stomach is reattached to the duodenum before the common bile duct.
Resection is sometimes a part of a treatment plan, [2] but duodenal cancer is difficult to remove surgically because of the area that it resides in—there are many blood vessels supplying the lower body. Chemotherapy is sometimes used to try to shrink the cancerous mass. Other times intestinal bypass surgery is tried to reroute the stomach to ...
Kocher figured out that by loosening it, the duodenum could be moved like it was in the early stages of development. [3] Kocher also knew that the duodenum and pancreas are initially hanging freely in the belly, connected by a mesentery. The Kocher maneuver brings these organs back to their original position in the belly.
The Billroth II always follows resection of the lower part of the stomach . The surgical procedure is called a partial gastrectomy and gastrojejunostomy. The Billroth II is often indicated in refractory peptic ulcer disease and gastric adenocarcinoma. [1]
The actual resection starts with the cutting of the duodenum between holding or guy sutures. [9] The duodenum is temporarily closed with a sponge; the resection borders of the stomach are then determined. [9] A sewing instrument facilitates the final step of stomach removal. [9] The incision follows at an angle of 45 degrees to the lesser ...
Billroth I, more formally Billroth's operation I, is an operation in which the pylorus is removed and the distal stomach is anastomosed directly to the duodenum. [1] [2] The operation is most closely associated with Theodor Billroth, but was first described by Polish surgeon Ludwik Rydygier. [2] The surgical procedure is called a ...
a common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma) [5] a bile duct injury (e.g. cholecystectomy, iatrogenic, trauma) an infection/inflammation (e.g. pancreatic pseudocyst) Roux-en-Y choledochojejunostomy – indications same as Roux-en-Y hepaticojejunostomy. Roux-en-Y pancreas transplant [6]