Surgery is generally indicated whenpeptic ulcer diseasecauses pain or bleeding that doesn’t improve with non-surgical treatment.
The Graham patch can be done laparoscopically but may require open surgery in a medical emergency.
The surgery takes roughly two hours to complete.Recovery time depends on the severity of the perforation.
Illustration by Julie Bang for Verywell Health
It is sometimes used when the bleeding of an ulcer cannot be stopped with any other conservative means.
If the ulcer is located near the duodenum, the stomach may need to be reconnected to thesmall intestine.
Strategically severing the nerve may significantly reduce acid production.
Antrectomy may also lower the proportion of gastric chief cells lining the wall of the stomach.
A vagotomy is usually done along with an antrectomy as an open laparotomy or laparoscopic surgery.
Recovery times are similar to those for a gastrectomy.
There are several techniques that can be used for pyloroplasty.
Pyloroplasty can be performed laparoscopically or as an open surgery.
It is almost never performed by itself and is most commonly paired with vagotomy.
Recovery and a return to normal activities should take four to six weeks.
Who Shouldnt Get Stomach Ulcer Surgery?
Generally, the condition can be effectively treated with medication and lifestyle changes, rather than with surgical intervention.
Smoking and alcohol use can contribute to stomach ulcers, and stopping these habits can help an ulcer heal.
Sometimesdietary modifications, like avoiding spicy foods, can help control symptoms.
Stomach ulcer surgery would be done to alleviate your symptoms and prevent consequences to your overall health.
Call your healthcare provider or 911 if you are experiencing any signs of a medical emergency.
This can include non-invasive tests, as well as imaging obtained with an endoscopy.
You will also have blood tests, like acomplete blood count (CBC)to evaluate you foranemia.
What to Wear
Wear something comfortable to your surgery appointment.
ensure you have clothes that don’t have a tight waist to wear on your way home.
For instance, you might be directed to change the dose or stop blood thinners that you are taking.
You may have some pre-operative testing before you go to the pre-surgical area.
These tests may include a chest X-ray, CBC, blood chemistry panel, andurine test.
You will be asked to change into a hospital gown.
You will have your temperature, blood pressure, pulse, respiratory rate, and oxygen level checked.
You will need to have IV fluids and possibly a blood transfusion during this period.
A small area of your skin will be exposed where the incision will be placed.
Your skin will be cleansed before the surgery starts.
These steps are not necessary before endoscopic stomach ulcer surgery.
During the Surgery
Your surgical procedure will begin after the preparation steps.
The next steps will depend on which technique your surgeon is using to treat your peptic ulcer.
You shouldn’t feel any discomfort during this process.
Surgical tools that are inserted through the endoscopic gear will be used to treat and control ulcer bleeding.
When the treatment is complete, the endoscope is removed.
Your surgeon will cut a small opening in your stomach as well.
After the stomach ulcer is surgically treated, your surgeon will exit the peritoneum and the skin.
They will also cut through your peritoneum and into your stomach, near your peptic ulcer.
Once your surgery is complete, your surgical wound will be covered with a dressing.
Your anesthesia medication will be stopped, and your breathing tube will be removed.
You will be assessed for signs of complications, such as hematemesis, vomiting, and severe abdominal pain.
After a few hours, you will be asked to drink clear fluids.
Your medical team will ask you to slowly advance your food and drink liquids.
You will be given guidance regarding when to schedule follow-up appointments with your healthcare provider, as well.
Recovery
After surgery for a stomach ulcer, it will take time to fully heal.
The need for a drain usually corresponds with a slower recovery as well.
Any immediate postoperative complications, such as an infection or extensive swelling, can prolong full recovery.
That means keeping them dry and clean when you are bathing.
You will receive a prescription for pain medication, which should be used as directed.
You might also receive a prescription medication and dietary instructions to control constipation.
When to Call Your Healthcare Provider
Warning signs of complications to watch for include the following.
It is best not to push yourself when it comes to physical activity.
Possible Future Surgeries
Generally, a stomach ulcer surgery shouldn’t lead to future procedures.
This may include continued avoidance of smoking and alcohol, as well as acidic and spicy foods.
Summary
Stomach ulcer surgery is used when bleeding from peptic ulcer disease cannot be controlled.
2022 Jul 1;93(1):e12e16.
doi:10.12669/pjms.36.ICON-Suppl.1714
World Laparoscopic Hospital.Pyloroplasty.
2020;2020:5197201.doi:10.1155/2020/5197201
- Kim HU.Diagnostic and treatment approaches for refractory peptic ulcers.Clin Endosc.
A non-randomized comparative study from a teaching hospital.J Clin Diagn Res.2015;9(10):PC01-3.
