Types of Surgeries

Question 1

For treatment of duodenal perforation in poor operative candidates/unstable patients
Place viable omentum over perforation and tack into place with sutures

Answer 1

Graham patch

Question 2

Resection of a 1-2cm segment of each vagal trunk as it enters the abdomen on the distal esophagus, decreasing acid secretion

Answer 2

Truncal vagotomy

Question 3

What other procedure must be performed along with a truncal vagotomy?

Answer 3

“Drainage procedure”(pyloroplaty, antrectomy, gastrojujenostomy), because vagal fibers provide relaxation of the pylorus, and, if you cut them, the pylorus will not open

Question 4

Pyloroplasty performed with vagotomy to compensate for decreased gastric emptying

Answer 4

Vagotomy and pyloroplasty

Question 5

Remove antrum and pylorus in addition to vagotomy; reconstruct as a Bilroth I or II

Answer 5

Vagotomy and antrectomy

Question 6

What is the advantage of proximal gastric vagotomy(highly selective vagotomy)?

Answer 6

No drainage procedure is needed; vagal fibers to the pylorus arepreserved; rate of dumping syndrome is low

Question 7

Truncal vagotomy, antrectomy, and gastroduodenostomy

Answer 7

Billroth I
(Think: BI = ONE limb off of the stomach remnant)

Question 8

Gastric cancer or suspicion of gastric cancer

Answer 8

Contraindicated in Billroth I

Question 9

Truncal vagotomy, antrectomy, and gastrjejunostomy

Answer 9

Billrothe II (ThinkL BII = two limbs off of the stomach remnant)

Question 10

Dissection of the left lateral peritoneal attachments to the duodenum to allow visualization of posterior duedenum

Answer 10

Kocher’s maneuver