Surgery of GI Tract and its Complications

Question 1

where is the divide between upper and lower GI surgery?

Answer 1

hepatobiliary/pancreatic and above = upper

everything below = lower

Question 2

what are the branches of the superior mesenteric?

Answer 2

ileo/jejunal branches
ileocolic
right colic
middle colic

Question 3

what is involved in oesophagectomy?

Answer 3

removal of diseased part of oesophagus and stomach brought up into chest to meet healthy part

Question 4

what is Nissen Funduplication and why is it performed?

Answer 4

fundus wrapped around top of stomach

for GORD

Question 5

what is the danger of cholecystectomy?

Answer 5

risk of cutting common bile duct

if common bile duct is cut it can be fatal

Question 6

What does pancreatectomy involve?

Answer 6

can cause diabetes (if tail removed)
must give CREON after if removing part that produced enzymes (head)
Sometimes whole pancreas removed (only chance of survival in pancreatic cancer)

Question 7

stomas can be temporary or permanent, give examples of each

Answer 7

temp - eg emergency surgery for perforated bowel gets resection but too inflamed to join at the time but can reverse stoma after a few months once healed
Permanent - crohns, UC

Question 8

what complications can arise from GI tract surgery?

Answer 8

wound infection (superficial or deep)
anastomotic leak (leak at join due to blood supply)
paralytic ileus
bleeding/haematoma
short gut syndrome
adhesions
scars

Question 9

what can increase risk of anastamotic leak?

Answer 9

arteriopath

- diseased vessels (eg. calcification, atheromas etc)