[100 years after Billroth... Laparoscopic Billroth I and Billroth II distal stomach resection]

In the period October 1993-February 1994, we performed three distal stomach resection operations laparoscopically (two Billroth-II anastomoses, one Billroth-I anastomosis combined with truncal vagotomy). The first patient, 83-year old, presented a stenosing, bleeding, prepyloric, malignant Non-Hodgkin lymphoma. The second patient, 84-year old, presented an ulcerated, non-malignant leiomyoblastoma of the antrum. Due to the histological type of the tumors a radical lymphadenectomy was not performed. The partially resected stomach (two thirds) was removed in a lap sac through a 3.5 cm infraumbilical incision. The third patient presented a persisting, prepyloric ulcer combined with an almost complete stenosis of the pylorus. In all three cases, it was possible to follow the principles of conventional open surgery. The anastomoses were all stapled intracorporally, no intraabdominal complications occurred. However, the first patient died on the 21st postoperative day from cardiopulmonary failure, the remaining two patients were discharged on day 11/day 12 postoperatively.