["Wheeling-off" of the duodenum in gastric resection in hemorrhagic duodenal ulcer]

Truncal vagotomy associated with antrectomy is required in the treatment of terebrant and haemorrhagic ulcers of the first duodenum. The main problem lies in the closure of the duodenal stump. The "wheeling-off" procedure is a reliable technique which consist of separating the duodenum from the pancreas by carrying out dissection into the posterior wall of the duodenum, between its two muscular layers. Closure is obtained by means of a stappler. This procedure was performed in 23 patients without leakage or recurrent bleeding.