Partial Gastrectomy Periprocedural Care

Updated: Mar 09, 2017
  • Author: Vikram Kate, MBBS, MS, PhD, FACS, FACG, FRCS, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS; Chief Editor: Vinay Kumar Kapoor, MBBS, MS, FRCS, FAMS  more...
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Periprocedural Care

Patient Education and Consent

Partial gastrectomy performed in a medically fit patient results in lower mortality and morbidity than total gastrectomy does.

Patients should be aware of the extent of surgery and the physiologic disturbances that can result from it. Complications such as postoperative bleeding, delayed gastric emptying, early satiety, and nutritional deficiencies should be explained.

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Equipment

Partial gastrectomy is performed in an operating theater. The operating theater should be adequately equipped with the necessary surgical instruments and supplies, including suture materials (especially synthetic absorbable sutures), an ultrasonic scalpel, and staplers (circular, linear, and linear cutting). Appropriate laparoscopic instruments and monitors should be available for the performance of a laparoscopic partial gastrectomy.

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Patient Preparation

Patients with an obstructed stomach benefit from nasogastric decompression, gastric lavage, and fluid resuscitation. Nutritional status has a direct bearing on good anastomotic healing and should be optimized before surgery. Anemia, hypoproteinemia, and hypokalemia should be adequately corrected.

Anesthesia

General anesthesia with endotracheal intubation is standard practice. An epidural catheter can be placed for postoperative analgesia.

Positioning

Patients are positioned supine in a slight reverse Trendelenburg position.

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