What is a vagotomy and Antrectomy?
All types of vagotomy can be performed at open surgery (laparotomy) or by using a minimally invasive approach (laparoscopic or robotic). For the management of PUD, vagotomy is sometimes combined with antrectomy (removal of the distal half of the stomach) to reduce the rate of recurrence.
What is a Billroth II gastrojejunostomy?
Billroth II gastrojejunostomy is a procedure that has been performed for tumor or severe ulcer disease in the distal stomach.
What is the difference between Billroth 1 and Billroth 2?
A Billroth I is the creation of an anastomosis between the duodenum and the gastric remnant (gastroduodenostomy). A Billroth II operation is constructed by sewing a loop of jejunum to the gastric remnant (gastrojejunostomy).
What is an Antrectomy?
Antrectomy (distal gastrectomy) is a procedure in which the distal third of the stomach (the gastric or pyloric antrum) is excised. Gastrectomies are further defined by the type of reconstruction used to reestablish gastrointestinal (GI) continuity.
What is a truncal vagotomy?
A truncal vagotomy is the division of the anterior and posterior trunks 4-cm proximal to the GEJ. Removes the acetylcholine-mediated secretion of acid from parietal cells. Results in the accelerated emptying of liquids due to the removal of the vagally mediated receptive relaxation of the gastric fundus.
Why is truncal vagotomy done?
Truncal vagotomy. This type is commonly used with pyloroplasty or abdominal drainage to treat chronic peptic ulcers. It involves cutting one or more of the branches that split off the main trunk of the vagus nerve and travel down your esophagus to your stomach and other digestive organs.
What is truncal vagotomy?
What is the Billroth II procedure?
Billroth II, more formally Billroth’s operation II, is an operation in which a partial gastrectomy (removal of the stomach) is performed and the cut end of the stomach is closed.
When do you use billroth 2?
The Billroth II always follows resection of the lower part of the stomach (antrum). The surgical procedure is called a partial gastrectomy and gastrojejunostomy. The Billroth II is often indicated in refractory peptic ulcer disease and gastric adenocarcinoma.
How is a Antrectomy performed?
A distal gastrectomy or antrectomy removes part of the stomach and stitches the remainder with an opening into the small intestine. Antrectomy (distal gastrectomy) is a procedure that involves surgical removal of the lower 30% of the stomach (antrum).
What is truncal vagotomy how does it affect git functions?
Truncal vagotomy: The two main trunks (anterior and posterior) of the vagus nerve are cut above the place where the esophagus joins the stomach (gastroesophageal junction). A truncal vagotomy removes the nerve going through the entire gastrointestinal system including the liver, gallbladder, pancreas and bowels.
How is truncal vagotomy done?
What kind of gastrectomy is performed with Billroth 1?
Distal Gastrectomy with Billroth I or Billroth Ii Reconstruction. According to the type of disease (ulcer or carcinoma) and the location of the basic disease (duodenal ulcer, gastric ulcer, high-gastric ulcer), they are performed as antral, two-thirds, four-fifths, or high subtotal gastrectomy.
What are the uses of truncal vagotomy and antrectomy?
Truncal vagotomy and antrectomy is usually performed in the treatment of complications of peptic ulcer disease. Indications include perforation, hemorrhage, and obstruction.
What’s the difference between Bi and Billroth II reconstruction?
In the Billroth II (BII) reconstruction the gastrojejunostomy is performed end-to-side. As an alternative, Roux-Y (RY) reconstructions can be done (see Chapter 82 ). A decisive difference between the BI and BII procedure is that in BI reconstruction the duodenal passage remains intact.
What’s the difference between a roux en Y and a Billroth II?
Billroth II gastrojejunostomy. A Roux-en-Y gastrojejunostomy (as can be seen in Roux-en-Y gastric bypass procedures) has a different configuration than a Billroth II gastrojejunostomy. Some consider the Roux-en-Y a variation of a Billroth II procedure. A Billroth II may be converted into a Roux-en-Y, if necessary.