Endoscopy in Tuanku Jaafar Hospital Seremban. 2 cm ulcer. Given Pantoprazole + 2 types of antibiotics : Amoxycllin + Clarithromycin for 2 weeks. They are to kill the helicobacter pylori bacteria and heal the ulcer.
At SOPD Klinik Pakar T. J. Hosp. my biopsy showed CA cells : differentiate adenocarcinoma cells with signet ring (mad cells + aggressive types) Shock to hear that my stomach has to be cut out.
Had a CT Scan - Stomach X-Ray ( barium upper GI series ) Brief glance result : T2NoMo
( ie stage 2 cancer cells in the stomach wall muscles, lymph Nodes clear, no Metastasis - no cancer spread to other organs)
Met surgeon Dr Ramesh and was admitted into ward 8B at 11.00 am. Had light breakfast in the morning and agreed to fast till afternoon for another endoscopy to be done by Dr Ramesh.
In the ward, nurses draw blood for tests, BP 120/80, ECG heart reading normal,
anaestestic Dr Hafiz explained about epidural at my spine for the pain after op.
Afternoon, Dr Ramesh informed that he will cut out my gall-bladder as it shows stones in my CT Scan.
Operation : Lap staging, Lap assisted subtotal gastrectomy with D2 dissection, open cholecystectomy. Pre-op Diagnosis : Gastric Cancer
i) Perioperative Antibiotics : IV Unasyu 1.5 gm stat
ii) Operative Findings : lap staging- No liver, peritoneum nodules
No serosol involvement of tumour, No ascites,
No enlarged lymph node seen.
Probable stage : T1, N0, M0
Open Surgery : No probable tumour, only thickening at the lesser curvature felt,
No liver nodules, few small lymph nodes seen along the common hepatic
vessels and left gastric vessels.
Surgery Duration : 4 hr. 42 min. ( 10.15 am - 14.57 pm )
Anesthesia duration : 5 hr. 29 min. ( 9.35 am - 15.04 pm )
Dr Ramesh informed that he managed to save 1/4 of stomach. Gall bladder taken out.
Lymph nodes and part stomach taken for pathology tests. Waiting results.