Billroth I anastomosis using a circular stapler for corrosive gastric stricture - A novel technique

Abstract

Introduction: Resection and hand-sewn Billroth I reconstruction is the commonly carried out procedure for type I gastric strictures. The use of staplers for Billroth I anastomosis is limited. Here we describe a unique technique of Billroth I anastomosis using a circular stapler without a gastrotomy in a case of corrosive gastric stricture.
Case summary and Technique: A fourteen-year-old girl with Type I gastric stricture underwent resection of the pre-pyloric stricture and Billroth I reconstruction, for which the shaft of the circular stapler was inserted through the open end of the stomach and a side-to-end anastomosis of the posterior wall of the stomach with the end of the  duodenum was carried out. The distal cut open end of the stomach was closed with a linear cutter. The patient made an uneventful recovery.
Conclusion: A circular stapler can be used by this technique for Billroth I anastomosis for a pre-pyloric corrosive stricture without a need for additional gastrotomy for introducing the stapler.

Key words: corrosive stricture, circular stapler, gastrectomy, gastroduodenal  anastomosis