43631 Gastrectomy, partial, distal; with gastroduodenostomy

Name of the Procedure:

Partial Distal Gastrectomy with Gastroduodenostomy
Common Name: Partial Stomach Removal

Summary:

A partial distal gastrectomy with gastroduodenostomy is a surgical procedure in which the lower part of the stomach is removed, and the remaining portion is connected to the duodenum (the first part of the small intestine). This procedure aims to treat or manage various stomach conditions by physically altering the anatomy of the digestive system.

Purpose:

The procedure addresses conditions such as stomach cancer, severe peptic ulcers, and benign tumors. The goal is to eliminate the diseased part of the stomach, alleviate symptoms, prevent complications, and improve the patient's quality of life.

Indications:

• Stomach cancer located in the lower part of the stomach
• Chronic, severe, or bleeding peptic ulcers
• Benign stomach tumors causing obstruction or pain
• Non-cancerous but problematic growths or polyps

Preparation:

• Fasting: Patients are usually required to fast for at least 8 hours before the procedure.
• Medication Adjustments: Certain medications may need to be stopped or adjusted prior to surgery.
• Diagnostic Tests: Preoperative assessments often include endoscopy, imaging studies (like CT scans), and blood tests to evaluate overall health and the extent of the disease.

Procedure Description:

1. Anesthesia: The patient is administered general anesthesia.
2. Incision: A surgical incision is made in the abdomen.
3. Resection: The surgeon removes the lower part of the stomach.
4. Gastroduodenostomy: The remaining upper portion of the stomach is then connected to the duodenum.
5. Closure: The surgical incision is closed using sutures or staples. Tools/Equipment: Scalpels, retractors, sutures, surgical staples, and sometimes laparoscopic instruments.

Duration:

The procedure typically takes 2 to 3 hours to complete.

Setting:

The surgery is performed in a hospital operating room.

Personnel:

• General Surgeon or Surgical Oncologist
• Anesthesiologist
• Surgical Nurses
• Surgical Technicians

Risks and Complications:

• Common risks: Infection, bleeding, and anesthesia-related complications
• Rare risks: Leakage from the surgical connection (anastomosis), nutritional deficiencies, and long-term digestive issues Management includes antibiotic treatment for infections and additional surgeries to address any serious complications.

Benefits:

• Alleviation of symptoms such as pain, bleeding, and obstruction
• Removal of cancerous or dangerous tissues
• Improved quality of life and potentially increased survival rate in cancer patients Benefits may be realized shortly after recovery from surgery.

Recovery:

• Hospital Stay: Typically 5 to 7 days
• Postoperative Care: Pain management, gradual reintroduction of liquids, and then solid food
• Restrictions: Avoid heavy lifting and strenuous activities for several weeks
• Follow-Up: Regular follow-up appointments to monitor healing and nutrition

Alternatives:

• Endoscopic removal of tumors or ulcers (less invasive)
• Radiation or chemotherapy (for cancer patients)
• Medications to manage ulcers or other non-cancerous conditions

Each alternative has its pros and cons, such as being less invasive but potentially less effective or more appropriate based on the patient's specific condition.

Patient Experience:

• During the procedure, the patient will be under general anesthesia and will not feel any pain.
• After the procedure, there may be pain and discomfort managed by pain medications.
• Patients gradually progress from a liquid diet to solid foods and can expect to feel more normal within a few weeks. Comfort measures include adequate pain management and support from medical staff during recovery.