The Billroth II was done quite a bit until lately for ulcer patients. It's still being done for post gastric cancer patients. Edward Mason observed that his Billroth II patients had a difficult time keeping their weight in the normal range and figured out that a similar surgery would help the obese. At the time, the only surgery they had was the Intestinal bypass which more often than not, resulted in liver failure. This refinement was added to avoid the bile reflux of the loop gastric bypass.
Excuses are made like it's just too difficult, people move too often etc.
One clinic said they had done some 8000 RNYs since 1980. Even at a few hundred a year for that many years, there should be all kinds of folks with gastric bypasses walking around but they seemed to all have disappeared. The procedure was questionable in the long run, he wrote. I am concerned about the goals of surgeons and patients and their level of interest in what really goes on inside the body after alterations of the anatomy. I am concerned about the focus on the superficial and results from the first year with a lack of concern about how life will be affected when patients are 10 and 20 years older.