subtotal gastrectomy with gastrojejunostomy.pptx

subtotal gastrectomy with gastrojejunostomy surgical overview

1. SUBTOTAL GASTRECTOMY WITH GASTROJEJUNOSTOMY Dr. Atul Khare

2. OUTLINE OF PRESENTATION SURGICAL ANATOMY INDICATION PREOPERATIVE EVALUATION SURGICAL TECHNIQUE COMPLICATIONS AND ITS MANAGEMENT

3. anatomy

4. y

5. Operative steps

6. Operative steps

7. Intraoperative complications Intraoperative 1] haemorrhage 2] acute ischemia of left lobe of liver 3] injury to spleen, pancreas, common bile duct 4] disruption of ampulla of vater

8. Immediate complications Immediate 1] atelectasis 2] pneumonia 3] respiratory failure 4] pulmonary embolism 5] deep venous thrombosis 6] wound infection 7] sub phrenic abscess 8] acute pancreatitis

9. Early complications 1] post operative anastomotic haemorrhage 2] anastomotic leak 3] duodenal stump leak 4] small bowel obstruction 5] stomal obstruction

10. Late complications 1] anastomotic stricture 2] marginal ulcer bleeding 3] gastro-gastric fistula 4] Post-gastrectomy syndrome= -gastric reservoir dysfunction [ dumping syndrome, metabolic disorders ] -vagal denervation’s [ diarrhoea, gastric stasis, gallstone] -aberrations in surgical reconstruction [ alkaline reflux gastritis, aff and eff loop obstruction, roux syndrome ] 5] small stomach syndrome 6] stump carcinoma

11. THANK YOU