Last updated: 11/24/2009

If a gastroduodenostomy is performed for gastric cancer, diagnosis is usually established using the following tests:

• Endoscopy and barium x rays. The advantage of endoscopy is that it allows for direct visualization of abnormalities and directed biopsies. Barium x rays do not facilitate biopsies, but are less invasive and may give information regarding motility.
• Computed tomagraphy (CT) scan. A CT scan of the chest, abdomen, and pelvis is usually obtained to help assess tumor extent, nodal involvement, and metastatic disease.
• Endoscopic ultrasound (EUS). EUS complements information gained by CT. Specifically, the depth of tumor invasion, including invasion of nearby organs, can be assessed more accurately by EUS than by CT.
• Laparoscopy. This technique allows examination of the inside of the abdomen through a lighted tube.

The diagnosis of gastric ulcer is usually made based on a characteristic clinical history. Such routine laboratory tests as a complete blood cell count and iron studies can help detect anemia, which is indicative of the condition. By performing high-precision endoscopy and by obtaining multiple mucosal biopsy specimens, the diagnosis of gastric ulcer can be confirmed. Additionally, upper gastrointestinal tract radiography tests are usually performed.

Preparations for the surgery include nasogastric decompression prior to the administration of anesthesia; intravenous or intramuscular administration of antibiotics; insertion of intravenous lines for administration of electrolytes; and a supply of compatible blood. Suction provided by placement of a nasogastric tube is necessary if there is any evidence of obstruction. Thorough medical evaluation, including hematological studies, may indicate the need for preoperative transfusions. All patients should be prepared with systemic antibiotics, and there may be some advantage in washing out the abdominal cavity with tetracycline prior to surgery.