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Billroth's operation I

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Removal of lower portion of stomach (pylorus) with end to end anastomosis of the remaining stomach with the duodenum.

In Billroth I the anastomosis is made directly to the duodenum, while in Billroth II the proximal duodenal remnant is closed off and the gastric stump connected to the jejunum

Billroth first performed the operation in 1881 on a 43 year old woman with pyloric cancer. A 14 cm portion of stomach was excised and an anastomosis fashioned with about 50 carbolised silk sutures.

The first resection of the stomach for cancer was performed by Jules Émile Péan (1830-1898), the second by Ludwik Rydigier (1850-1920) in 1880. Rydigier introduced the technique of resection better known as the Billroth I procedure.

We thank Paul Rotmil for calling our attention to the eponym "Rydigier's resection".


  • J. E. Péan:
    De l'ablation des tumeurs de l'éstomac par gastrectomie.
    Gazette des Hôpitaux, 1879, 52: 473-475.
    First gastrectomy for carcinoma – unsuccessful.
  • L. Rydigier:
    Wyçiecie raka odŸwiernika zol¹dkowego, œmieræ w 12 godzinach.
    Przeglad lekarski, Warsaw, 1880, 19: 637-639.
    First extirpation of carcinomatous pylorus. Death after 12 hours.
    German translation in Deutsche Zeitschrift für Chirurgie, 1881, 14: 252-260.
  • C. A. T. Billroth:
  • Offenes Schreiben an Herrn Dr. L. Wittelshöfer.
    Wiener medizinische Wochenschrift, 1881, 31: 161-165, 1427.
    First successful resection of the pylorus for cancer.
    Open letter to Leopold Wittelshöfer (1818-1889), the publisher of Wiener medizinische Wochenschrift.

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