43810 Gastroduodenostomy

Name of the Procedure:

Gastroduodenostomy
Commonly known as: Billroth I procedure

Summary

A gastroduodenostomy is a surgical procedure where part of the stomach is removed and the remainder is attached directly to the duodenum, which is the first section of the small intestine.

Purpose

Medical Condition Addressed:

• Stomach cancer
• Peptic ulcer disease
• Severe gastric ulcers or complications

Goals/Expected Outcomes:

• Remove diseased or affected portions of the stomach
• Restore normal digestion process
• Alleviate pain and improve nutritional intake

Indications

• Persistent or severe peptic ulcers not responding to medical treatment
• Obstructions in the stomach or duodenum
• Gastric tumors or cancers
• Complications from previous gastric surgeries

Preparation

Pre-procedure Instructions:

• Fasting for at least 8 hours prior to surgery
• Stopping certain medications (e.g., blood thinners) as instructed by the healthcare provider
• Arranging post-operative care and transportation

Diagnostic Tests/Assessments:

• Blood tests
• Imaging studies (e.g., CT scan, X-ray)
• Endoscopy

Procedure Description

1. Anesthesia: General anesthesia is administered.
2. Incision: An abdominal incision is made to access the stomach and duodenum.
3. Resection: The diseased portion of the stomach is removed.
4. Anastomosis: The remaining part of the stomach is directly attached to the duodenum.
5. Closure: The incision is closed with sutures or staples.
6. Monitoring: The patient is monitored in the recovery area before being transferred to a hospital room.

Tools/Equipment Used:

• Surgical scalpels
• Sutures or surgical staplers
• Anesthesia equipment

Duration

Typically takes between 2 to 4 hours.

Setting

Performed in a hospital operating room.

Personnel

• General surgeon or gastrointestinal surgeon
• Anesthesiologist
• Surgical nurses
• Post-operative care team

Risks and Complications

Common Risks:

• Infection
• Bleeding
• Leakage at the site of anastomosis

Rare Risks:

• Nutritional deficiencies
• Dumping syndrome (rapid gastric emptying)
• Strictures or blockages in the reconnected areas

Management of Complications:
Monitoring, medications, or additional surgeries as needed.

Benefits

• Relief from symptoms of ulcer or obstruction
• Removal of cancerous tissues
• Improved digestion and nutritional absorption

Benefit Realization:

• Immediate relief may be seen post-surgery, with full benefits realized over time as recovery progresses.

Recovery

Post-procedure Care:

• Hospital stay of 5-7 days
• Gradual reintroduction of liquids and soft foods
• Pain management with prescribed medications

Expected Recovery Time:
4-6 weeks for complete recovery

Restrictions/Follow-up:

• Avoid heavy lifting or strenuous activities
• Follow-up appointments for monitoring and assessment

Alternatives

Other Treatment Options:

• Medical management (medications, lifestyle changes)
• Endoscopic treatments (for some ulcer conditions)

Pros and Cons:

• Medical management is less invasive but may be less effective for severe conditions.
• Endoscopic treatments are minimally invasive but may not address all underlying issues like cancer.

Patient Experience

During Procedure:

• Under general anesthesia, so no conscious experience of the surgery.

After Procedure:

• Some pain and discomfort manageable with medication
• Gradual return to normal diet and activities
• Regular follow-up visits to ensure successful recovery.