Types of partial gastrectomy
The key types of partial gastrectomy are:
- Bilroth type I
- Polya-type gastrojejunal anastomosis
For both, preoperative preparation of the patient is important and involves:
- correction of anaemia
- improving nutritional state, e.g. vitamin supplementation
- medical therapy to reduce the size of the ulcer is large, e.g. H2-antagonists for duodenal ulceration
After general anaesthesia, the region is approached by a midline epigastric or right upper paramedian incision. After a general inspection to define the site of any peptic lesion, the gastrointestinal tract is quickly surveyed for concomitant disease.
Post-operatively, a nasogastric tube may be used to warn of haemorrhage from a suture line. Initial IV fluids are followed by oral fluids after 24-48 hours and then a liquid diet for the subsequent week.
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