BILLROTH 1 FOR CORROSIVE ANTRAL STRICTURE- OUR EXPERIENCE
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2018, Vol 5, Issue 34
Abstract
BACKGROUND Ingestion of caustic agents and injury to the alimentary tract remain an important issue in the public health domain. The spectrum of injury secondary to caustic ingestion can vary from a few erosions to full thickness necrosis and perforation. Stomach, an organ with reservoir function takes the brunt of the injury when larger quantities of alkali is ingested. Gastric cicatrisation is a well-known delayed complication of such an ingestion. Herein we present a single centre experience of 6 years of dealing with corrosive antral strictures in an elective surgical scenario. MATERIALS AND METHODS This was a retrospective study of a prospectively maintained database, obtained from hospital information record system, carried out at a tertiary referral centre in India. All records and surgical procedural notes of patients admitted between 2012 and 2018 were reviewed. A total of 26 patients who underwent reconstructive surgery for gastric antral cicatrisation were included in the study. Patients with a concomitant oesophageal reconstruction were excluded. Resection was preferred to a bypass procedure and the extent of resection was determined by a pre-operative oesophagogastroduodenoscopy and an intra operative assessment of the remnant stomach. RESULTS A total of 26 patients underwent surgery during the study period with a predominant male patient population (10F, 16M). The median age of the study group being 34.3 years (20- 56 years). The time interval between ingestion of corrosive to definitive management ranged between 1m to 11m with a median of 5.2 months. All patients underwent antrectomy and stapled end to side gastroduodenostomy procedure. The median post-operative hospital stay being 7.3 days (4-24 days). 2 patients had anastomotic stricture during follow up, 1 patient had an anastomotic leak and 1 patient had abdominal wound dehiscence. The median duration of follow up for all these patients was 18 months. CONCLUSION Antrectomy and Billroth 1 reconstruction for cicatrised antrum secondary to corrosive ingestion is an apt surgical procedure with a low complication rate and less morbidity especially when the timing of surgical intervention has been appropriate.
Authors and Affiliations
Hunasanahalli Giriyappa Venugopal, Boppasamudra Nanjegowda Vinay, Mariappa Casaba Shilpa
Keywords
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- EP ID EP571074
- DOI 10.18410/jebmh/2018/512
- Views 107
- Downloads 0
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