Here are the list of some surgical procedure that are very effective and advisable to those patient with PUD that are candidate for surgery. Before that you're doctors knows best as to what is the right surgical procedure needs to be done. Let me start with vagotomy, truncal vagotomy, selective vagotomy, pyloroplasty, antrectomy and anastomosis.
Vagotomy - severing of the vagus nerve, which decreases gastric acid by diminishing cholenergic stimulation to the parietal cells, making them less responsive to gastrin. May beperformed to reduce gastric acid(cause of ulcer) secretion. A drainage type of procedure is usually performed to assist with gastric emptying as there is total denervation of the stomach. Some patients have problems with feelings of fullness, dumping syndrome, diarrhea and gastritis.
Truncal vagotomy - severing of the right and left vagus nerves as they enter the stomach at the distal part of the esophagus. This type of vagotomy is most commonly used to decrease acid secretions and reduce gastric and intestinal motility. Recurrence rate is 10% - 15%.
Selective vagotomy - severing of vagal innervation to the stomach but maintains innervation to the gastric antrum and pylorus. There is no dumping syndrome and no need for drainage procedure. The recurrence rate is 10% - 15%.
Pyloroplasty - a surgical procedure in which a longitudinal incision is made into the pylorus and transversely sutured closed to enlarge the outlet and relax the muscle. Usually accompanies truncal and selective vagotomies, which produce delayed gastric emptying due to decreased innervation.
Antrectomy ( Billroth I -gastroduodenostomy, Bilroth II - gastrojejunostomy ) - removal of the lower portion of the antral portion of the stomach which contains the cells that secrete gastrins as well as small portion of the duodenum and pylorus. The remaining segment is anastamosed to the duodenum ( Billroth I ) or jujenum ( Billroth II ). May be performed in conjuction with a truncal vagotomy. The patient may have problems with feeling of fullness, dumping syndrome and diarrhea. The recurrence rate is <1%.
Subtotal gastrectomy with Billroth I or II anastomosis - removal of distal third stomach; anastomosis with duodenum or jejunum. Removes gastrin- producing cells in the antrum and part of the parietal cells. Dumping syndrome, anemia, malabsorption, weight loss may happen but the recurrence rate is 10% - 15%.
Vagotomy - severing of the vagus nerve, which decreases gastric acid by diminishing cholenergic stimulation to the parietal cells, making them less responsive to gastrin. May beperformed to reduce gastric acid(cause of ulcer) secretion. A drainage type of procedure is usually performed to assist with gastric emptying as there is total denervation of the stomach. Some patients have problems with feelings of fullness, dumping syndrome, diarrhea and gastritis.
Truncal vagotomy - severing of the right and left vagus nerves as they enter the stomach at the distal part of the esophagus. This type of vagotomy is most commonly used to decrease acid secretions and reduce gastric and intestinal motility. Recurrence rate is 10% - 15%.
Selective vagotomy - severing of vagal innervation to the stomach but maintains innervation to the gastric antrum and pylorus. There is no dumping syndrome and no need for drainage procedure. The recurrence rate is 10% - 15%.
Pyloroplasty - a surgical procedure in which a longitudinal incision is made into the pylorus and transversely sutured closed to enlarge the outlet and relax the muscle. Usually accompanies truncal and selective vagotomies, which produce delayed gastric emptying due to decreased innervation.
Antrectomy ( Billroth I -gastroduodenostomy, Bilroth II - gastrojejunostomy ) - removal of the lower portion of the antral portion of the stomach which contains the cells that secrete gastrins as well as small portion of the duodenum and pylorus. The remaining segment is anastamosed to the duodenum ( Billroth I ) or jujenum ( Billroth II ). May be performed in conjuction with a truncal vagotomy. The patient may have problems with feeling of fullness, dumping syndrome and diarrhea. The recurrence rate is <1%.
Subtotal gastrectomy with Billroth I or II anastomosis - removal of distal third stomach; anastomosis with duodenum or jejunum. Removes gastrin- producing cells in the antrum and part of the parietal cells. Dumping syndrome, anemia, malabsorption, weight loss may happen but the recurrence rate is 10% - 15%.
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