Gastroenterostomy
In medicine, gastroenterostomy (GE) is the surgical connection between the stomach and the small intestine .
indication
A gastroenterostomy is performed to treat passage disorders in the stomach and duodenum . Causes can be tumors of the stomach, the head of the pancreas or the biliary tract as well as inflammatory changes.
A gastroenterostomy is often performed if the actual cause of the obstructed passage cannot or should not be removed. Gastroenterostomy is often performed as a palliative procedure.
Op principle
The actual tightness is left during the operation. An anastomosis is made between the stomach and jejunum . For this purpose, the top jejunal loop is sewn or clamped to the side of the stomach.
The food and gastric juice are bypassed the narrowness and arrive from the stomach directly into the small intestine without passing through the pylorus and duodenum .
Elimination of pain, positioning and access
The procedure is usually performed under general anesthesia with the supine position slightly hyperextended. An additional PDA catheter ( catheter close to the spinal cord) placed before the operation (preoperative) can save painkillers during the operation and makes pain management easier after the operation.
The operation is performed through an abdominal incision ( laparatomy ), but occasionally also minimally invasive ( laparoscopic ).
Risks and Complications
Non-specific surgical risks are intra- and postoperative bleeding, wound healing disorders, formation of incisional hernias , thrombosis , pulmonary embolism and postoperative pneumonia .
A specific risk is the risk of anastomotic leakage . Peritonitis threatens here if the anastomotic leakage is not recognized in time.
literature
- Henne-Bruns, Dürig, Kremer: Dual series surgery . Thieme, 3rd edition, Stuttgart 2008, ISBN 978-3-13-125293-7
- Schumpelick: Surgery atlas . Thieme, 2nd edition, Stuttgart 2006, ISBN 978-3-13-140632-3 .
