Page 2 of 3: surgery--stomach

asd · Credits: 811 My Scrapbook

proton pump inhitors work as good as vagotomy
I used to perform Graham omentoplasty and adminestrate omeprazle it works well
.that was when I was a resident in surgery. I am a radiologist now. dont know what the books say nowadays

the site of ca is lesser curvature.

drsmita_s · Credits: 18609 My Scrapbook

niyati2002 · Credits: 5492 My Scrapbook

THANX A LOT GUYS...AMIT-ASHISH 'VE WRITTEN D ANS ..''ANTRUM...thou' i was well sure it to be LC...

jayanta · Credits: 34873 My Scrapbook My Reading List 45 Books

AGREED.

syndrome_xy · Credits: 10937 My Scrapbook

wots the final answer? is vagotomy with pyloroplasty less commonly done than vag with antrectomy?

dr_ameya · Credits: 406 My Scrapbook

I'm a bit confused about the most common site of gastric cancer.
The figure in Bailey on pg 1051 gives the incidences of gastric cancer only in the UK
The text says 'Proximal stomach is the most common site for gastric cancer in the West.

Amit Ashish gives reference of the samw question from CSDT,Schwartz and Robbins.
CSDT says-"40% of tumours are in the antrum,predominantly on the lesser curvature....."
That makes it all the more confusing as both 'lesser curvature' and 'antrum' are given in the options...

So I'm still confused...

What is the right answer?!

umesh_yes · Credits: 120 My Scrapbook

highly selective vagotomy

jabby · Credits: 3703 My Scrapbook

VAGOTOMY AND ANTERECTOMY.
LESSER CURVATURE.

aminhars · Credits: 13205 My Scrapbook

Why is Peptic Ulcer Surgery performed ?

If you have a peptic ulcer, it is likely that it can healed with drugs. However, some ulcers may be resistant to treatment and others will recur when medication is stopped.
Two types of peptic ulcer occur gastric (stomach) and duodenal

1--- Operations are done for gastric ulcers that do not heal with medical treatment because there is a small risk that the ulcer may be malignant.

2---When chronic duodenal ulcers produce scarring of the outlet of the stomach preventing it from emptying (pyloric stenosis), operation is needed.

3---Emergency surgery will be required if an ulcer bleeds, or if it bursts through the stomach wall causing a hole (perforation).

for intractable duodenal ulcer disease
it needs acid reducing procedure
I--truncal vagotomy/antrectomy (TV + A);
II--gastric selective vagotomy/pyloroplasty (GSV + P);
III--proximal gastric vagotomy (PGV)
in 1---least recurrance but much complication
2---some recurrance and some complications
3---some recu. and least complications

so wht i think is the best is highly selective in UNCOMPICATED peptic ulcer
BUT may b most commonly done (as in question) may b TV+antrectomy

aminhars · Credits: 13205 My Scrapbook

now some more concepts

if COMPLICATED PEPTIC ULCER (perforated)

STABLE----laparoTOMY-->repair + highly selective(proximal) vagotomy

UNSTABLE----ceilotomy-->now

new ulcer-->close + omental patch

CHRONIC case-->not highrisk
< 12 hrs
no extensive perito.spillage

-->TV+antrectomy

--->if any of above--->withhold operation

so
in stable HIGHLY SELESTIVE

in unstable--TV + ANTRECTOMY

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