Subtotal Gastrectomy and Its Anatomical Basis

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Subtotal Gastrectomy and Its Anatomical Basis
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Range of stomach to be removed

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Billroth ?

Subtotal Gastrectomy
Hofmeisters method
Polyas method
Billroth ?
Moynihans method
V.Eiselsbergs method
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?Hofmeister
?Moynihan

?V.Eiselsberg
?Polya
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Operation procedure

• 1. Incisionepigastric mid-line incision

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2. Exploration

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3. Liberation of stomach
Celiac trunk
Short gastric artery
Splenic artery

Common hepatic artery
Left gastrtic artery
Lesser omentum
Right gastric artery
gastroduodenal artery
Left epiploic artery
Right epiploic artery
Greater omentum
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• 4. Cut off and remove distal part of stomach.
• 5. Billroth ?anastomosis of rest of stomach and
  duodenum.
• Billroth ?close remnant terminal of
  duodenum, anastomosis of stomach and jejunum.
• 6. Close abdominal cavity, operation finished.

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Tighten the connection point formed by anterior
and posterior wall of stomach and duodenum