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[Videolaparoscopy gastrectomy for complicated peptic ulcer: technique and case report]
M A Machado1, J R da Rocha, R Z Abdalla
1Hospital Brigadeiro, São Paulo.
Arquivos De Gastroenterologia
|February 7, 2001
Summary
Laparoscopic Billroth II gastrectomy offers a minimally invasive surgical option for intractable peptic ulcers. This technique, using endoscopic stapling, allows for faster recovery and reduced pain compared to open surgery.
Area of Science:
- Gastroenterology
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Medical management for peptic ulcer disease has reduced surgical indications.
- Surgical intervention remains necessary for complications like bleeding, perforation, obstruction, and intractable ulcers.
- Laparoscopic Billroth II gastrectomy, first performed in 1992, is a less common surgical approach.
Observation:
- A 48-year-old male with a 20-year history of peptic ulcer presented with severe epigastric pain.
- Gastroscopy revealed a duodenal ulcer and bulbar deformity, leading to a diagnosis of intractable peptic ulcer.
- The patient underwent a totally laparoscopic Billroth II gastrectomy with side-to-side intracorporeal gastrojejunostomy using endoscopic stapling devices.
Findings:
- The patient experienced a rapid recovery, ambulating on postoperative day 1.
- He tolerated a clear liquid diet by postoperative day 3 and was discharged on postoperative day 6.
- Postoperative recovery was characterized by minimal pain and no need for narcotic analgesia.
Implications:
- Totally laparoscopic Billroth II gastrectomy is a viable alternative to open surgery for selected patients with intractable peptic ulcers.
- The use of endoscopic stapling devices facilitates intracorporeal gastrojejunostomy, contributing to the minimally invasive nature of the procedure.
- This approach may lead to improved patient outcomes, including reduced postoperative pain and shorter hospital stays.