Gastrectomy is the excision of the affected part of the stomach, followed by suturing of the remaining parts. If this is not possible, create a fistula ( anastomosis ) of the stomach with the intestine. According to the size of the removed part of the stomach, resection can be partial or complete (total). Theodore Billroth developed two typical ways of resection of the stomach. In the first method (Billroth I), after removal of the affected part of the stomach, the non-dried part of its stump is sutured end-to-end with the duodenal stump. This method is considered the most physiological, as food masses pass through the duodenum and are exposed to bile and pancreatic juice. In the second method (Billroth II), the duodenal stump is sutured tightly and a fistula (anastomosis) is placed between the remaining part of the stomach and the upper segment of the jejunum. There are several modifications to the imposition of this fistula.
Gastroduodenostomy is the imposition of a fistula between the stomach and the duodenum. The front surface of the stomach and the descending part of the intestine are brought closer together and a fistula is placed between them (Fig. 3). Currently used very rarely, mainly when it is difficult to evacuate contents from the stomach.
Gastrojejunostomy - see Gastroenterostomy .
Gastropexy is the hemming of the stomach (with its omission) to the anterior abdominal wall, the left lobe of the liver and the round ligament, the peritoneum, etc. It is not currently used, as it leads to an extensive adhesive process in the abdominal cavity and constant pain. Other operations on the stomach - see Gastrectomy, Gastrostomy, Gastrostomy, Gastroesophagostomy.
A set of instruments for operations on the stomach should consist of the usual ones used in laparotomy (see Surgical instruments), with the obligatory addition of a large gastric pulp superimposed on the stomach during its resection, and a small superimposed on the duodenum.