Billroth II Gastrojejunostomy in Dogs Stapling Technique and Postoperative Complications

Abstract

Billroth II gastrojejunostomy was performed with surgical staplers in 6 dogs that were not irradiated and in 11 dogs that subsequently received radiation to the pancreas and proximal part of the duodenum. The dogs were monitored clinically for 135 days and then euthanatized and necropsied. Each gastrojejunostomy site was preserved in formalin and the stomal diameter was measured. No mechanical complications were encountered with the use of surgical staplers and no leakage was observed at the staple closure sites before abdominal closure. All dogs vomited approximately 100 ml of coagulated blood 4 to 8 hours after surgery, and 300 to 400 ml of brown fluid after approximately 24 hours. Vomiting was the most common clinical finding after the first 24 hours. Vomiting was subjectively graded from 1 to 3 with grade 1 representing the least severe problem and grade 3 the most severe. Grade 1 vomiting occurred in 12 of 16 dogs that survived 135 days; in the other four dogs, vomiting was classified as grade 2 or 3. All dogs with grade 1 vomiting had stomal diameters of 1.7 to 2.9 cm (mean, 2.2 +/- 0.4 cm standard deviation). Dogs with grade 2 or 3 vomiting had stomal diameters of 2.2 to 4.0 cm (mean, 3.2 +/- 0.8 cm standard deviation). The difference was statistically significant (p less than 0.005). The percentage of weight gained or lost was recorded for each dog. Two nonirradiated dogs gained body weight, whereas the other nonirradiated dogs and all irradiated dogs lost body weight.(ABSTRACT TRUNCATED AT 250 WORDS)

Surgical Stapling Devices in Veterinary Medicine: A Review

“…Instruments with rotating and articulating heads ease staple application in difficult‐to‐reach areas 4 . In animals, TA staplers have been used for ovarian pedicle, vaginal, and uterine stump closure; partial or complete lung lobectomy; removal of right atrial appendage tumors; cyst resection; typhlectomy; esophageal resection; partial splenectomy, nephrectomy, prostatectomy, or pancreatectomy; partial or complete hepatic lobectomy; end‐to‐end intestinal anastomosis; closure of Heinecke–Mikulicz pyloroplasty; repair of rectal tears; and closure of gastrointestinal and urinary bladder incisions 2,5–27 . I have also used TA staplers for transanal removal of rectal polyps in dogs.…”

“…Staples must engage the opposing, full‐thickness walls of the viscus to ensure a secure seal. Besides GIAs, these devices have been used for partial gastrectomy, Finney pyloroplasty, typhlectomy, gastropexy, cholecystoenterostomy, Janeway tube gastrostomy, prostatic cyst resection, partial lung lobectomy, and esophageal and rectal diverticulum resection 2–4,6,7,11,15,20,22,28–37 …”

“…Complications. With stapled GIAs complications include reduced lumen diameter, adhesions, leakage with subsequent peritonitis, gastrointestinal ulcerations, severe hemorrhage, and anal dysfunction 5,19,22,31,42,51,52,59,66–72 . Anastomotic stomal diameter can be affected by surgical technique and degree of postoperative inflammation.…”

Successful vascularized jejunal patch graft to treat severe orad duodenal injury secondary to foreign body obstruction in a dog

“…[3][4][5] Orad duodenal defects may require more complex surgical management because of the proximity of the pancreatic and common bile ducts as well as the major and minor duodenal papillae. 6,7 This report documents the successful repair of a large orad duodenal defect with a jejunal patch graft, a technique that has not been previously reported in clinical veterinary medicine.…”

Megaesophagus was Complicated with Billroth I Gastroduodenostomy in a Cat

“…After removal of the affected part, the remaining parts of the stomach and duodenum are attached together using end-to-end anastomosis [1,10,14]. The procedure is also used to remove gastric neoplasm.…”