Laparoscopic Conversion of Billroth I to Roux–Y Gastrojejunostomy for Bile Reflux Gastritis and Chronic Gastric Outlet Obstruction

R J Rosenthal, I Fendrich, A Abdemur, S Szomstein. Cleveland Clinic Florida

Introduction: Gastric outlet obstruction due to anastomotic stricture is a possible complication of partial gastrectomy with a Billroth I reconstruction. We present a case in which a stenotic BI anastomosis after open partial gastrectomy was converted to a Roux en Y utilizing a laparoscopic technique.

Case Report: A 59-year-old female with a previous surgical history of open Billroth I gastric resection due to chronic ulcer disease presented with complains of nausea, vomiting, upper abdominal pain, and weight loss. Upper GI series revealed a distended stomach along with delayed emptying and slow passage of contrast into the duodenum. Upper endoscopy revealed a narrow, gastroduodenal anastomosis. The patient underwent a laparoscopic distal gastrectomy and reconstruction of the gastrointestinal tract in a Roux-en-Y fashion. Postoperative upper GI series showed no leak or obstruction. The postoperative period was unremarkable and the patient was discharged home on postoperative day 4 tolerating a PO diet.

Conclusion: Laparoscopic conversion of Billroth I to Roux-en-Y gastrojejunostomy is a safe and feasible option.

Session: VidTV1
Program Number: V051

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