The Responsibility of the Surgeon who Performs Gastric Surgery extends beyond Concern with Operative Technique, immediate mortality and must encompass the rehabilitation of the Patient, including Nutritional Rehabilitation.
The complications which may follow Gastric Resection are Numerous and a Number of them may be listed
1) Dumping Symdrome
2) Excessive Fecal Nutrient Loss and Weight Loss
3) Anemia
4) Hypoglycemia
5) Blow out of Duodenal Stump
6) marginal ulcer with Bleeding, Perforation a Gastro-jejunocolic Fistula 7) Gastric Retention following Resection
The major factor in undernutrition following gastric surgery appears to be failure of patients to eat an adequate amount of food. This appear to be due to dumping symdrome, A diet high in protein and fat and low in carbohydrate given in multiple small feedinqs will improve the nutritional states, and both protein and fat appear to be absorbed in a constant ratio to the amount ingested. Therefore, moderate increase in both protein and fat can result in adequate absorption,
After total Gastrectomy in man the ability to absorb vitamin B12 from the gastro intestenal tract is lost and megaloblastic macrocytic anamia occurs two or more years after opuation.
Hypochromic anemia occurs with moderate frequency, particularly in females after gastric surgery and it is assumed that this, tendency toward anamia is due to impared ability to abdorb iro, nor in some patients, continues -´occult Bleeing from Gastrointestinal tract.
Following gastric surgery a high Percentage of patients show abnormalities in response to glucose and insuline tolerance tests, abnormally high elevation of the blood sugar. level in first hour after oral intake, and abnormally low depression in the second or hirrd hours.
A result of defect in technique during surgery and their subsequent complications such as blow out of duodenal stump
Occurrence of marginal ulcer, and gastric retention following resection his been discussed.
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