Procedures for Benign and Malignant Gastric and Duodenal Disease

Question 1

Complications of PUD:

Answer 1

hemorrhage, perforation, and obstruction

Question 2

Most commonly, duodenal perforation is treated with

Answer 2

closure and omental patching, with or w/o an acid-reducing procedure

Question 3

A bleeding ulcer is treated with

Answer 3

oversewing of the bleeding vessel, with or w/o an acid-reducing vagotomy or pyloroplasty

Question 4

Gastric outlet obstruction may be managed by

Answer 4

vagotomy with antrectomy and vagotomy with drainage via pyloroplasty or gastroenterostomy

Question 5

Perforated duodenal ulcers are typically treated by

Answer 5

oversewing the perforation, then placing a portion of the greater omentum over the suture line

Question 6

Highly selective vagotomy is ___ likely to result in dumping syndrome and postvagotomy diarrhea

Answer 6

less

Question 7

For a Heineke-Mikulicz pyloroplasty:

Answer 7

a full thickness longitudinal incision is made that extends from a point 1 cm proximal to the pylorus to a point 1 to 2 cm distal to the pylorus. The incision is closed transversely in two layers. Superior and inferior stay sutures help align the incision for closure.

Question 8

For the truncal vagotomy:

Answer 8

the peritoneum over the EGJ is opened widely to afford exposure Gentle downward traction is applied to the stomach to facilitate identification of the 2 vagus nerves. Surgical clips are applied to each nerve in turn, and a 2 to 3 cm nerve segment is removed and inspected.

Question 9

In a Finney pyloroplasty:

Answer 9

the distal stomach and proximal duodenum are aligned with stay sutures. An inverted U-shaped incision is made. The pyloroplasty is created in two layers.

Question 10

Antrectomy removes the ____ portion of the stomach. It is typically combined with truncal vagotomy.

Answer 10

gastrin-secreting