[A case of papillary disinsertion during gastro-duo-denectomy for ulcer of the second part of the duodenum and its repair by a "physiological" reconstruction (author's transl)].

The authors report a personal case of repair of papillary disinsertion. They emphasise the risk of retrograde dissection of an old stenosing duodenal ulcer, the importance of peroperative recognition of this accident by cholangiography, the interest of sphincterotomy to attempt to prevent secondary stenosis of the papilla, the absolute necessity of an anastomosis preventing anastomotic ulcer by contact between the mouth of the gastro-enterostomy and the alkaline secretions. Vagotomy seems to them a useful complementary procedure but, associated with a drainage procedure, they believe it might have avoided this severe complication.