The procedure that removes the lower portion of the stomach and a small part of the duodenum and then creates an anastomosis of the jejunum to the stomach is called:

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The procedure described is a Billroth II (gastrojejunostomy), which involves removal of the lower portion of the stomach and duodenum and creation of an anastomosis between the jejunum and the remaining portion of the stomach. This allows for continued mixing of bile and pancreatic enzymes with ingested food. Vagotomy and antrectomy (B) removes the lower portion of the stomach and the nerve supply to decrease gastric acid secretion, while vagotomy and pyloroplasty (C) also decreases acid secretion but involves widening of the pylorus. Highly selective parietal cell vagotomy (A) is a more limited nerve-cutting procedure that is used to decrease acid secretion without removing any stomach tissue. Billroth I (gastroduodenostomy) involves removal of the distal stomach and anastomosis to the duodenum, which can result in bile reflux and stomal ulceration. The procedure described is Billroth II (gastrojejunostomy), which involves the removal of the lower portion of the stomach and a small part of the duodenum, followed by the creation of an anastomosis of the remaining stomach with the jejunum. Vagotomy and antrectomy (B) involves the removal of the lower portion of the stomach as well as the antrum, while vagotomy and pyloroplasty (C) involves cutting the vagus nerve and making an incision in the pyloric sphincter to allow for better gastric emptying. Highly selective parietal cell vagotomy (A) is a type of vagotomy that only cuts the nerves that stimulate acid secretion in the stomach. Billroth I (gastroduodenostomy) (D) involves creating an anastomosis between the remaining stomach and the duodenum, instead of the jejunum.

The Procedure That Removes the Lower Portion of the Stomach