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Typically, it is between stomach and small bowel that is distal (or further down the gastrointestinal tract) from the cut end. The first anastomosis led to the afferent (in retrograde) and efferent limbs, and the second anastomosis led to the afferent limb in antegrade fashion (a). The opening in continuity with the efferent limb leads to the distal jejunum, the second opening leads to a blind distal end of the afferent limb, and the third one leads to the duodenum through the afferent limb (see fig
With billroth ii or loop gj the afferent limb conducts bile, pancreatic juices, and other proximal intestinal secretions toward the gj 51 Egd revealed billroth ii anatomy with 2, not 1, gastrojejunal (gj) anastomoses After surgery, your bile and digestive fluids enter the afferent limb
The fluids then flow toward the upper stomach
They need to pass through the anastomosis and then enter the part of the small intestine that empties from the stomach (called the efferent limb).
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