Billroth 1: Surgical Management of Pediatric Gastric Outlet Obstruction: Our Institutional Experience: A Case Series

Gastric outlet obstruction (GOO) is a late complication of corrosive ingestion, particularly in children. Although corrosive injuries primarily affect the esophagus, involvement of the pyloric antrum with progressive stenosis is also common. Optimal surgical management remains debated, and evidence supporting the use of Billroth 1 reconstruction continues to evolve. The study reviews eight patients who developed corrosive acid-induced GOO and underwent surgical intervention. All patients were evaluated clinically and radiologically to assess the severity of obstruction. The operative procedure primarily consisted of antrectomy with gastroduodenostomy (Billroth 1) based on intraoperative findings and the extent of fibrosis. Postoperative outcomes, symptom resolution, and ability to tolerate feeds were assessed during follow-up. All eight patients had pyloric obstruction with marked antral fibrosis. Billroth 1 reconstruction was successfully completed in all cases. Postoperatively, patients demonstrated early return of gastric emptying and tolerated oral feeds well. All patients remained asymptomatic, exhibited weight gain, and showed no evidence of recurrence or postoperative complications on follow-up. The procedure provided definitive relief and restored normal physiological continuity of the gastrointestinal tract. Corrosive-induced GOO requires individualized management based on the extent of injury and patient condition. Through this manuscript, we advocate Billroth 1 as a safe and effective treatment of GOO with good short- to mid-term outcomes.