Figure 2. The demolitive (upper left panel) and the reconstructive (upper right panel) phases of pancreaticoduodenectomy when a short afferent loop is present in a previous B II partial gastrectomy. The afferent loop is stapled and removed within the specimen, whereas the efferent loop is stapled (upper left panel) and its distal end utilized for the pancreatic and bile duct anastomoses (upper right panel). This procedure has been followed in Case #1. The demolitive (lower left panel) and reconstructive (lower right panel) phases follow the above described steps also when a short afferent loop to the jejuno-jejunal anastomosis is present in a Roux-en-Y partial gastrectomy.