Mnemonic:
1. 1 is Less
2. 2 is Two
3. 3 is Pre-
4. 4 is Door
5. 5 is 5 letter (NSAID)
| Type | Mnemonic | Location | Acid hypersecretion | Complications | Surgery |
|---|---|---|---|---|---|
| I (55%) | Less | Lesser curvature | No | Bleeding uncommon | Distal gastrectomy with BI, BII or RY GJ anastomosis |
| II (20%) | Two | 1 gastric + 1 duodenal or pre-pyloric | Yes | Bleeding, perforation, obstruction | Antrectomy or Distal gastrectomy with BI, BII or RY GJ anastomosis+ Vagotomy |
| III (20%) | Pre | Pre-pyloric | Yes | Bleeding, perforation | Antrectomy BI, BII or RY GJ anastomosis + Vagotomy |
| IV (<5%) | Door | Gastroesophageal | No | Bleeding | Subtotal gastrectomy with RY GE anastomosis |
| V (<5%) | 5 letter (NSAID) | Anywhere | No | Bleeding, perforation |
BI = Billroth I – gastroduodenal anastomosis
BII = Billroth II – gastrojejunal anastomosis
RY GJ anastomosis = Roux-en-Y Gastrojejunal anastomosis
RY GE anastomosis = Roux-en-Y Gastroesophageal anastomosis
