消化性潰瘍疾患 V: 外科的管理と看護ケア

Surgical interventions for peptic ulcer disease include vagotomy, with or without pyloroplasty, to reduce gastric acid secretion by transecting a portion of the vagus nerve.

In contrast, pyloroplasty widens the pyloric channel to improve gastric emptying.

Next, partial gastrectomy includes antrectomy, the excision of the distal third of the stomach, or subtotal gastrectomy, which entails removing both the middle and distal thirds.

After excision, the stomach is anastomosed either to the duodenum, called gastroduodenostomy or Billroth I, or to the jejunum, known as gastrojejunostomy or Billroth II.

Postoperative nursing management includes monitoring vital signs, maintaining NPO status, administering analgesics and IV fluids, using a nasogastric tube for gastric decompression, and recording intake and output.

Encourage early ambulation to prevent complications such as pulmonary embolism and inspect the surgical site for signs of infection, such as redness.

Be vigilant for signs of complications like abdominal pain, hematemesis, and fever, which may indicate an anastomotic leak, hemorrhage, or infection.