Summary
A 78-year-old man with severe diabetes mellitus fell into shock due to bleeding from multiple gastric ulcers. Near-total gastrectomy without reconstruction was performed in the initial operation to save his life. After his general condition improved, total gastrectomy with Roux-en-Y esophagojejunostomy was performed in a second procedure. As this two stage total gastrectomy can avoid excessive operative stress, and prevent rebleeding and breakdown at the anastomosis, we consider it a valuable procedure for patients who have multiple bleeding gastric ulcers involving almost the whole stomach, and who have very poor general condition or severe complications at the time of operation.
Similar content being viewed by others
References
Hirao M, et al: Hemostatic procedure by endoscope for gastrointestinal bleeding—Clinical practice of endoscopic local injection of hypertonic sodium epi nephrine (HS-E) solution. Stomach & Intestine 15: 751, 1980 (Jpn)
Asaki S: Tissue solidification in coping with digestive tract bleeding — Hemostatic effect of local injection of 99.5% ethanol. Tohoku J exp Med 134: 223, 1981
Rutgeerts P, et al: Controlled trial of YAG laser treat-ment of upper digestive hemorrhage. Gastroen-terology83:410, 1982
Menguy R, et al: The surgical management of acute gastric mucosal bleeding. Arch Surg 99: 198, 1969
Bubric MP, et al: Control of acute gastroduodenal hemorrhage with cimetidine. Surgery 84: 510, 1978
Stothert JC, et al: Randomized prospective evaluation of cimetidine and antacid control of gastric pH in the critically ill. Ann Surg 192: 169, 1980
Kameyama J, et al: Acute gastric mucosal lesions-Experimental and clinical studies on acute gastroduo-denal ulcer in obstructive jaundice. Jpn J Gastroent Surg 15: 1641, 1982 (Jpn)
Kitajima M, et al: Gastric mucosal lesions after burn injury — Relationship to H+ back-diffusion and the microcirculation. J Trauma 18: 644, 1978
Cody HS, et al: Choice of operation for acute gastric mucosal hemorrhage — Report of 36 cases and review of literature. Am J Surg 134: 322, 1977
Hubert JP, et al: The surgical management of bleed-ing stress ulcers. Ann Surg 191:672, 1980
Kameyama J, et al: Management of multiple organ failure after surgery of digestive organs —With special reference to postoperative acute gastroduodenal ulcers. JJpnSurgSoc83: 1136, 1982 (Jpn)
Wilson WS, et al: Superficial gastric erosions —Re-sponse to surgical treatment. Am J Surg 126: 133, 1973
Pruitt BA, et al: Stress ulcer disease in the burned pa-tient. World J Surg 5: 209, 1981
Drapanas T, et al: Experiences with surgical manage-ment of acute gastric mucosal hemorrhage — A unified concept in the pathophysiology. Ann Surg 173: 628, 1971
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Ameyama, Ji., Katagiri, S., Yagi, S. et al. Two stage total gastrectomy in a case of multiple bleeding gastric ulcers. Gastroenterol Jpn 20, 148–152 (1985). https://doi.org/10.1007/BF02776679
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02776679