Surgery (MCQ) Questions

Q) What is true regarding complications of billroth 2 surgery?

a) It has less complications than billroth 1 surgery

b) Recurrent ulceration is more common in the afferent limb as compared to efferent limb.

c) Afferent loop obstruction is more common after billroth 2 surgery

d) Billroth I operation is preferred in scarred duodenum

 

Answer c -

In billroth 2 surgery, afferent limb obstruction is more common

In surgery for benign gastric ulcers, billroth I reconstruction is the preferred choice. Billroth II surgery has problems of

1. Retained antrum syndrome
2. Afferent loop obstruction
3. Duodenal stump leak (1-3%)

Billroth 2 surgery is done when there is

1. Inadequate mobility of the duodenum

2. Scarring of duodenum

Complications of gastric surgery
Complications of gastrectomy

1. Nutritional and weight loss - Iron deficiency, Copper deficiency, Vit B12 , Anemia
2. Delayed gastric emptying
3. Roux statsis- Seen in roux en y loops-  Pain, nausea, vomiting, abdominal bloating
4. Cholelithiasis-  Higher incidence in roux en y reconstruction as compared to B1 and B 2 gastrectomy
5. Recurrent ulceration

Complications of Billroth 2 surgery

1. Dumping syndrome
2. Afferent loop obstruction - It can be minimized by keeping the length of afferent loop less than 20 cm and using a retrocloic approach.
3. Bile reflux gastritis - More common with billroth I and billroth 2 surgery, incidence is decreasing after the use roux en y anastomosis