GI surgery Flashcards
What type of operations are emergency operations?
Normally open, except lap appendix
When are drains inserted?
Normally with emergency surgery
What is upper GI surgery?
Oesophagus, gastric, hepatobiliary and pancreatic
What is lower GI surgery?
Small and largre bowel and rectum
What is a ‘hot gallbladder’?
Emergency gall bladder
When is a stoma brought out?
When it is unsafe to rejoin (peritonitis, emergency surgery)
When there is nothing to rejoin to.
When there is chronic inflammation: UC or chron’s
Can you have a temporary and permanent stoma?
Yes.
If you’ve had emergency surgery it may not have been appropriate to anastamose the bowel initially but it can be done electively later.
What are the complications of surgery?
Superficial or deep wound infections Anastamotic leak Paralytic ileus Bleeding/haematoma Short gut syndrome Adhesions and scarring
When do anastamotic leaks become apparent?
3-5 days is needed to ensure a good blood supply.
What happens if there is an anastamotic leak in the small bowel?
Generally can be stitched up- no bacteria
What happens if there is an anastamotic leak in the large bowel?
Stoma due to bacteria in the gut.
How long can paralytic ileus last?
Normally 3-5 days
If >7 days TPN must be considered. No point using entral feeding.
