Types of partial gastrectomy

The key types of partial gastrectomy are:

• Bilroth type I
• Polya-type gastrojejunal anastomosis

For both, preoperative preparation of the patient is important and involves:

• correction of anaemia
• improving nutritional state, e.g. vitamin supplementation
• medical therapy to reduce the size of the ulcer is large, e.g. H2-antagonists for duodenal ulceration

After general anaesthesia, the region is approached by a midline epigastric or right upper paramedian incision. After a general inspection to define the site of any peptic lesion, the gastrointestinal tract is quickly surveyed for concomitant disease.

Post-operatively, a nasogastric tube may be used to warn of haemorrhage from a suture line. Initial IV fluids are followed by oral fluids after 24-48 hours and then a liquid diet for the subsequent week.