Intersecting staple lines and blood flow in oesophagojejunal anastomoses

✍ Scribed by T. K. Hunt

• Publisher: John Wiley and Sons
• Year: 1991
• Tongue: English
• Weight: 139 KB
• Volume: 78
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.1800780541

✦ Synopsis

I suggest that the correct choice of operative procedure for bleeding duodenal ulcer is as follows: high risk patients (APACHE I1 greater than 10) should be treated with T V + P and careful underrunning of the bleeding point or ulcer bed. If a giant ulcer or severe scarring are present gastroenterostomy is preferable to pyloroplasty. Low risk patients (APACHE I1 lower than 1 1 ) can be safely managed with a direct attack on the bleeding point followed by a highly selective vagotomy. Gastrectomy is rarely, if ever, indicated. I believe that the above policy may allow the uncomplicated survival of more patients as well as more stomachs , . .