[Verse 1]
Stomach's gone, resected clean, but the body ain't finished yet
Postgastrectomy syndromes creeping in, something the surgeon can't forget
Early dumping hits in thirty minutes, hyperosmolar food hits the gut
Fluid shifts into the lumen rapid, blood pressure drops, pulse cuts
Vasomotor chaos — flushing, cramping, palpitations on the clock
Osmotic overload in the jejunum, distension causing shock
Late dumping's different — two hours out, reactive hypoglycaemia strikes
Glucose surges, insulin overcooks, then the patient's shaking, white
[Chorus]
D-A-A-R-M-P — remember every complication's name
Dumping, Alkaline, Afferent, Roux stasis, Marginal, Postvagotomy's game
Manage it medically or revise the anatomy
Roux conversion, Henley loop — surgical anatomy
[Verse 2]
Alkaline reflux gastritis — bile swimming where it shouldn't be
Billroth reconstruction lets the duodenal contents roam free
Epigastric burning, nausea, vomiting bile, pain that food won't calm
Endoscopy shows erythema, histology confirms the harm
Afferent loop syndrome — the biliopancreatic limb obstructs
Acute distension, bilious vomiting after eating, pressure erupts
Efferent loop's the exit blocked — obstruction further down the run
Roux stasis syndrome — motility's arrested, nothing's getting done
[Chorus]
D-A-A-R-M-P — remember every complication's name
Dumping, Alkaline, Afferent, Roux stasis, Marginal, Postvagotomy's game
Manage it medically or revise the anatomy
Roux conversion, Henley loop — surgical anatomy
[Verse 3]
Postvagotomy diarrhea — cut the vagus, gut motility's unhinged
Watery explosive episodes, the colon cramping unrestrained
Cholestyramine binds the bile salts, codeine slows the transit pace
Gastroparesis stalls the remnant, prokinetics bought to take its place
Marginal ulcer forms at the anastomosis, acid's final stand
Ischaemia, tension, Helicobacter — triple threat the surgeon planned
PPI therapy first line always, but recurrence needs a scope
Check for fistula, revise if needed — don't just hand the patient hope
[Bridge]
Remnant gastric cancer lurking, fifteen to twenty years delayed
Bile reflux mutating mucosa, intestinal metaplasia laid
Surveillance scoping every three years minimum past decade five
Billroth Two carries highest risk, keep that endoscope alive
Roux-en-Y conversion redirects the bile limb, solves the reflux source
Henley interposition — isoperistaltic jejunum charts a different course
Sixty centimetres minimum on the Roux limb, any less and stasis wins
Know the physiology before you pick the operation — that's where mastery begins
[Chorus]
D-A-A-R-M-P — remember every complication's name
Dumping, Alkaline, Afferent, Roux stasis, Marginal, Postvagotomy's game
Manage it medically or revise the anatomy
Roux conversion, Henley loop — surgical anatomy