This document outlines a presentation on subtotal gastrectomy with gastrojejunostomy surgery. It discusses the surgical anatomy, indications for the procedure, preoperative evaluation, surgical technique, and potential complications including intraoperative, immediate, early, and late complications. Complications range from hemorrhage and ischemia during surgery to anastomotic leaks, strictures, marginal ulcers, and dumping syndrome in the long term. The document provides an overview of the key aspects of performing and recovering from this type of stomach surgery.

1. SUBTOTAL GASTRECTOMY WITH
GASTROJEJUNOSTOMY
DR. ATUL KHARE

2. OUTLINE OF PRESENTATION
• SURGICAL ANATOMY
• INDICATION
• PREOPERATIVE EVALUATION
• SURGICAL TECHNIQUE
• COMPLICATIONS AND ITS MANAGEMENT

3. ANATOMY

7. • Y

8. OPERATIVE STEPS

9. OPERATIVE STEPS

10. INTRAOPERATIVE COMPLICATIONS
INTRAOPERATIVE
1] HAEMORRHAGE
2] ACUTE ISCHEMIA OF LEFT LOBE OF LIVER
3] INJURY TO SPLEEN, PANCREAS, COMMON BILE DUCT
4] DISRUPTION OF AMPULLA OF VATER

11. IMMEDIATE COMPLICATIONS
IMMEDIATE
1] ATELECTASIS
2] PNEUMONIA
3] RESPIRATORY FAILURE
4] PULMONARY EMBOLISM
5] DEEP VENOUS THROMBOSIS
6] WOUND INFECTION
7] SUB PHRENIC ABSCESS
8] ACUTE PANCREATITIS

12. EARLY COMPLICATIONS
1] POST OPERATIVE ANASTOMOTIC HAEMORRHAGE
2] ANASTOMOTIC LEAK
3] DUODENAL STUMP LEAK
4] SMALL BOWEL OBSTRUCTION
5] STOMAL OBSTRUCTION

13. LATE COMPLICATIONS
1] ANASTOMOTIC STRICTURE
2] MARGINAL ULCER BLEEDING
3] GASTRO-GASTRIC FISTULA
4] POST-GASTRECTOMY SYNDROME=
-GASTRIC RESERVOIR DYSFUNCTION [ DUMPING SYNDROME, METABOLIC DISORDERS ]
-VAGAL DENERVATION’S [ DIARRHOEA, GASTRIC STASIS, GALLSTONE]
-ABERRATIONS IN SURGICAL RECONSTRUCTION [ ALKALINE REFLUX GASTRITIS, AFF AND
EFF LOOP OBSTRUCTION, ROUX SYNDROME ]
5] SMALL STOMACH SYNDROME
6] STUMP CARCINOMA

14. THANK YOU