GASTROENTEROSTOMY FOR

General Information

DEFINITION--Creation of an artificial passage between the stomach and the small intestine to bypass obstructions caused by ulcer scar tissue.

BODY PARTS INVOLVED--Stomach; duodenum; jejunum (usually).

REASONS FOR SURGERY--Restoration of normal function of the gastrointestinal tract.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Newborns and infants.
• Stress.
• Obesity.
• Smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Recent or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.

What To Expect

WHO OPERATES--General surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; gastroscopy; x-rays of upper gastrointestinal tract; serum electrolytes (See Glossary).
• After surgery: Blood and urine studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the upper abdomen.
• The abdominal muscles are separated to expose the abdominal organs, which are inspected for any undetected disease. Other surgeries may be performed at this time.
• The stomach and jejunum are isolated. A small opening is made in each, and they are joined with sutures at the openings. Usually combined with vagotomy (see in Surgery section) to prevent ulceration of stoma.
• The abdominal muscles are closed with sutures. The skin is closed with sutures or clips, which usually can be removed in about 1 week.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Spillage of stomach contents into abdomen.
• Incisional hernia.

AVERAGE HOSPITAL STAY--7 to 10 days.

PROBABLE OUTCOME--Expect complete healing without complications. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Stool softeners to prevent constipation. > Antibiotics to fight infection.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. > Resume driving 1 month after returning home.

DIET--Nasogastric suction is used; followed by clear liquid diet until bowel starts to function. Then eat a well--balanced diet to promote healing. Avoid coffee, tea, cocoa, cola drinks, alcoholic beverages and any food or spice that causes indigestion.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation, abdominal swelling or black, tarry stools.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.