SURGICAL MANAGMENT OF

BYDr. Pirah Korai

FCPS-ii TRAINEECMC LARKANA

OUTLINES

Introduction

Diagnosis

Medical management

Surgical management

DIAGNOSIS

UGIS (Double contrast studies)

Endoscopy

MANAGMENT

Conservative

Regular lifestyle

Prohibition of the smoking and alcohol

Diet (proteins, milk and milky products)

MEDICAL OPTIONS

Antacids

Anticholinergics

H2 Blockers

PPIs

SURGICAL MANAGMENT

INDICATIONS

Intractable ulcers

Life threatening complications of ulcer (e.g bleeding, perforation, obstruction)

DUODENAL ULCER

Billroth ll Gastrectomy

Gastrojejunostomy

Truncul vagotomy and drainage

Higly selective vagotomy

Truncul vagotomy and antrectomy

Billroth ll operation

Billroth l Gastrectomy

COMPLICATIONS

Recurrent ulcerationSmall stomach syndromeBile vomitingEarly dumpinglate dumpingPostvagotomy diarrheaMalignant transformationNutritional consequencesGall stones

COMPLICATED PEPTIC ULCER