Open Antrectomy, Duodenal Resection, and Gastrojejunostomy for a Multiple Endocrine Neoplasia Tumor
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Procedure Outline
After adequate general endotracheal anesthesia was obtained, the patient was sterilely prepped and draped in standard fashion.
- Midline abdominal incision, enter peritoneum
- Entry of Lesser Sac using Wide Kocher Maneuver
- Evaluation of Pylorus and Duodenum
- Ligation of right gastroepiploic artery and right gastric artery
- Examine Pylorus and Duodenum for tumor
- Division of Duodenum
- Mobilization of stomach and division of short vessels along the lesser and greater curvature
- Resection of Antrum and send specimen for pathology
- Mobilization of Jejunum to stomach in retrocolic fashion
- Two layer anastomosis
- Interrupted 3-0 silk (outer layer)
- Running 3-0 Vicryl (inner layer)
- Lembert Sutures
- Bring anastomosis through trap and suture in place
- Abdominal Fascia closed with #1 Running Prolene
- Skin closed with staples