Procedures Related to Ulcers & Neoplasm

Question 1

Gastroduodenostomy
Billroth 1

Answer 1

. Antrectomy removes distal portion of
stomach and pylorus
. Reanastomosis is to the duodenum
. Preferred approach

Definition/Purpose:
. Antrectomy removes the distal portion of the stomach and the pylorus
. Reanastomosis is to the duodenum

Notes:
. When unresponsive to conservative treatment

Question 2

Gastrojejunostomy
Billroth 2

Answer 2

. Antrectomy removes distal portion of the
stomach and pylorus
. Reanastomosis is to the jejunum
. Preferred when duodenum is scarred
. End of duodenum must be closed

Definition/Purpose:
. Antrectomy removes the distal portion of the stomach and the pylorus
. Reanastomosis is to the jejunum

Notes:
. Preferred when the duodenum is scarred
. End of duodenum must be closed

Question 3

Gastrectomy

Answer 3

. Removal of the stomach
. Partial or total gastrectomy may be performed for other conditions
. Requires Roux-en-Y antecolic esophagojejunostomy or end to side antecolic esophagojejunostomy

Definition/Purpose:
. Removal of the stomach
. Partial or total gastrectomy may be performed for other conditions

Notes:
. More difficult technically, partial is preferred for longterm patient prognosis unless the entire stomach is involved with tumor
. Requires a Roux-en-Y antecolic esophagojejunostomy or end-to-side antecolic esophagojejunostomy