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8355 Surgery

A 30 yr old male patient presented with massive haemetemesis. Upper GI endoscopy shows a 2×2 cm ulcer on the posterior aspect of the first pa of the duodenum. Bleeding vessel is seen, but could not be controlled endoscopically. Patient’s pulse rate is 100, BP 110/70, Hb 10 gms% after blood transfusion. What will be the next line of management is:

AIV pantoprazole
BPaial gastrectomy including the bleeding segment
CDuodenotomy, with ligation of bleeding vessel, truncal vagotomy with pyloroplasty
DDuodenotomy, ligation of bleeding vessel with truncal vagotomy, antrectomy
Surgery
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