BILLROTH-II RESECTION WITH MODIFIED NISSEN DUODENOJEJUNOSTOMY FOR DUODENAL-ULCER HEMORRHAGE ASSOCIATED WITH DUODENAL STRICTURE

Between January 1988 and December 1992, six patients presenting with c hronic duodenal ulcer disease, long segment duodenal stricture, gross gastric dilatation and Forrest Ia hemorrhage from penetrating posterio r duodenal wall ulcer were managed by oblique duodenal transsection, s uture ligation of arroded pancreaticoduodenal vessel, classic Billroth II resection, Nissen duodenojejunostomy and a Tomoda valve disconnect ing the Nissen anastomosis from the gastroenterostomy, - resulting in a functional ''uncut'' Roux anastomosis. The procedure was expeditious and safe in this patient population, with an uneventful recovery and satisfactory functional results.