Technical aids in surgery. Gastroduodenostomy for the "difficult" duodenum.

Many techniques have been devised for the safe closure of the 'difficult' duodenal stump after Billroth II gastrectomy. It is suggested that, in the presence of a 'difficult' duodenum and when gastrectomy is unavoidable, gastroduodenal anastomosis obviates the potential hazards of the high-risk duodenal stump.