History of the Operation
The Bilroth 2 gastrectomy:
Christian Albert Theodor Billroth described the operation which bears his name.
It was designed to allow the removal of stomach tumours.
The operation connected the small bowel to the remaining portion of stomach:
As you can see from the diagram:
Food passes directly into the small bowel and does not enter the duodenum.
This operation is still in use today for cancer of the distal stomach.
It became clear that after this operation patients would invariably lose weight and for many years this was thought to be due to the reason why the patient required the operation, rather than the operation itself: the disease having somehow left a lasting effect on the patient.
This now known to be untrue and the effects are now attributed to a change in the levels of certain chemical messengers brought about by the change in pathway taken by food.
This change in the pathway is now exploited for the very purpose of resolving diabetes and losing weight.