Recurrent Ulcer Surgery

Recurrent ulcer after gastrectomy occurs mostly at the edge of the anastomosis or on the side of the jejunum, so it is also called anastomotic ulcer. If the ulcer is complex, widely distributed in the upper part of the stomach or jejunum, it should be considered as Zhuo-Ehrlich syndrome. Further examination and determination of gastrin quantification should be carried out to focus on the presence or absence of functional adenomas in the pancreas, duodenum or residual stomach. If the adenoma is found to be removed, a total gastrectomy should be performed. Treatment of diseases: recurrent ulcer, gastric ulcer, anastomotic ulcer Indication Recurrent ulcer after gastrectomy occurs mostly at the edge of the anastomosis or on the side of the jejunum, so it is also called anastomotic ulcer. If the ulcer is complex, widely distributed in the upper part of the stomach or jejunum, it should be considered as Zhuo-Ehrlich syndrome. Further examination and determination of gastrin quantification should be carried out to focus on the presence or absence of functional adenomas in the pancreas, duodenum or residual stomach. If the adenoma is found to be removed, a total gastrectomy should be performed. Contraindications Aged and debilitated, poor function of important organs such as heart and lung Preoperative preparation Take care to prevent infection. Surgical procedure Recurrent ulcer after gastrectomy occurs mostly at the edge of the anastomosis or on the side of the jejunum, so it is also called anastomotic ulcer. If the ulcer is complex, widely distributed in the upper part of the stomach or jejunum, it should be considered as Zhuo-Ehrlich syndrome. Further examination and determination of gastrin quantification should be carried out to focus on the presence or absence of functional adenomas in the pancreas, duodenum or residual stomach. If the adenoma is found to be removed, a total gastrectomy should be performed. If the duodenal stump has a residual gastric antrum, the residual gastric antrum mucosa should be completely removed. For patients with excessive stomach, the anastomosis and part of the corpus call including ulcers may be removed, or the vagus nerve can be removed. The latter is less burdensome to the patient and equally satisfactory. For penetrating recurrent ulcers, patients with gastric jejunal colon fistula should be removed, not only the resection of the residual stomach and the repair of the fistula or partial resection of the colon, but also the removal of the vagus nerve. complication The incidence of recurrent ulcers and blood is 50% to 60%, and the amount of bleeding is large and fatal. The incidence of perforation is 1% to 5%. See more chronic penetration, penetration into the colon can cause stomach-jejunum-colon fistula, the incidence rate is about 10%, at this time there are more abdominal pain, diarrhea, indigestion, hernia, fecal odor or vomiting with feces, Soon to lose weight.