The Billroth I gastric resection along with truncal vagotomy is frequently performed for intractable duodenal ulcer or benign gastric ulcer. The procedure may be performed when hemigastrectomy is carried out for a variety of other reasons. It is hoped that this reconstruction to a normal configuration will result postoperatively in few symptoms and improved nutrition.

The stomach is aspirated preoperatively, and nasogastric suction is maintained. Antibiotics are given to patients with achlorhydria, since they may have significant bacterial colonization of the duodenum or stomach.

Routine general anesthesia is given via a cuffed endotracheal tube.

The patient is placed supine on the table in a modest reverse Trendelenburg position.