Gastrectomy
all information

Gastrectomy

(Total Gastrectomy; Partial Gastrectomy; Subtotal Gastrectomy; Stomach Removal)

Pronounced: gas-TREK-tuh-mee

En Español (Spanish Version)

Definition

An operation to remove all or part of the stomach.

Abdominal Organs, Anterior View

gastro intestinal stomach

© 2008 Nucleus Medical Art, Inc.

Parts of the Body Involved

  • Stomach
  • Pylorus
  • Duodenum
  • Small intestine
  • Esophagus

Reasons for Procedure

Gastrectomy is most often performed to treat stomach cancer . It may also be used in some cases to treat ulcer disease, bleeding, inflammation, blockage, or benign tumors in the stomach.

Risk Factors for Complications During the Procedure

  • Obesity
  • Increasing age
  • Smoking
  • Poor nutritional status
  • Having a chronic condition such as respiratory disease or cardiac disease

What to Expect

Prior to Procedure

Your doctor will likely do the following:

  • Physical exam
  • Blood tests
  • Fecal occult blood test (FOBT)—a test to check for blood in the stool
  • Endoscopy—exam of the esophagus, stomach, and duodenum using a thin, lighted tube inserted through the mouth
  • Upper GI Series —x-rays of the stomach and esophagus while drinking a barium suspension
  • CT Scan —an x-ray that uses computers to make pictures of structures inside the body

In the days leading up to your procedure, your doctor may recommend that you:

  • Follow a special diet
  • Take antibiotics
  • Shower the night before your procedure using antibacterial soap
  • Arrange to have someone drive you to and from the procedure, and for help at home after your procedure
  • The night before, eat a light meal and do not eat or drink anything after midnight
  • Wear comfortable clothing

Anesthesia

You will be given general anesthesia medications through an intravenous needle that will put you to sleep for the duration of your surgery.

Description of the Procedure

The surgeon makes an incision in your abdomen over your stomach. Next, surgical instruments are used to remove part or all (total gastrectomy) of your stomach.

If only part of your stomach is removed (partial gastrectomy), the surgeon connects the remaining part of your stomach to your esophagus or small intestine. If the procedure is performed for ulcer disease, the nerves that control acid production may also be cut.

If all of your stomach is removed (total gastrectomy), the surgeon attempts to make a new “stomach” using your intestinal tissue. Then, the end of your esophagus is attached to your small intestine.

If you are having a gastrectomy due to stomach cancer, the surgeon will likely remove and examine lymph nodes during the procedure, since cancer can spread through your lymphatic system.

After the procedure is complete, the surgeon closes the muscles and skin of the abdomen with stitches or staples, and applies a sterile dressing.

After Procedure

The tissue that was removed will be sent to a pathologist for examination.

How Long Will It Take?

The surgery typically takes 1 to 3 hours or more.

Will It Hurt?

Anesthesia prevents pain during surgery. Patients typically experience pain during recovery, but receive pain medication to relieve the discomfort.

Possible Complications

  • Damage to neighboring organs or structures, such as the gallbladder and pancreas
  • Leaking from the new connection between the stomach, intestine, and/or esophagus
  • Infection
  • Bleeding
  • Incisional hernia
  • Blood clots in the vein (phlebitis) that may travel to the lungs ( embolism )
  • Hematoma (accumulation of blood in the wound)
  • Pneumonia and other risks of general anesthesia

Average Hospital Stay

The typical hospital stay after a gastrectomy is 6 to 12 days.

Postoperative Care

You will receive instructions on when and what you can eat, and how you need to restrict your activity. During the first few days after surgery, you may be restricted from eating. As your stomach stretches during your recovery, you will be able to eat more at a time. If you had a total gastrectomy, you will need to eat smaller amounts of foods more often.

It is possible that you may experience frequent heartburn , abdominal pain, and vitamin deficiencies after your gastrectomy. Your doctor may prescribe changes in your diet, medications, and/or vitamin supplements after your procedure.

Outcome

The outcome varies depending on why you had the gastrectomy. In the 1950s, almost 10% of people died after gastrectomies due to complications. But due to advances in surgical techniques, only about 1% to 2% of people today die after a gastrectomy. If you had a gastrectomy for benign disease, it is expected that you should return to a normal functional status postoperatively.

Gastrectomy is currently the only way to cure stomach cancer. The use of chemotherapy and radiation after surgery may help improve overall survival from stomach cancer. Even if the cancer is too advanced to be cured, gastrectomy can be beneficial in helping to prevent bleeding, obstruction, and pain.

Call Your Doctor If Any of the Following Occurs

It is essential for you to monitor your recovery once you leave the hospital. That way, you can alert your doctor to any problems immediately. If any of the following occurs, call your doctor:

  • Signs of infection, including fever and chills
  • Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
  • Cough, shortness of breath, chest pain, severe nausea, or vomiting
  • Pain, burning, urgency, frequency of urination, or persistent bleeding in the urine
  • Pain and/or swelling in your feet, calves, or legs, or sudden shortness of breath or chest pain

RESOURCES:

American Cancer Society
http://www.cancer.org

American Gastroenterological Association
http://www.gastro.org

National Cancer Institute
http://www.cancer.gov

CANADIAN RESOURCES:

BC Cancer Agency
http://www.bccancer.bc.ca/default.htm

Canadian Cancer Society
http://www.cancer.ca

References:

Stomach and esophageal cancer: what treatments are available? The Cancer Council Victoria website. Available at: http://www.cancervic.org.au/cancer1/patients/stomach/whattreatments.htm . Accessed September 28, 2005.

Stomach cancer: surgery. American Cancer Society website. Available at: http://www.cancer.org/docroot/CRI/content/CRI_2_4_4X_Surgery_40.asp?sitearea= . Accessed September 28, 2005.

Surgery to remove stomach cancer. Cancer Research UK website. Available at: http://www.cancerhelp.org.uk/help/default.asp?page=3917 . Accessed September 28, 2005.

What you need to know about stomach cancer. National Cancer Institute website. Available at: http://www.cancer.gov/cancertopics/wyntk/stomach/ . Accessed September 28, 2005.



Last reviewed November 2007 by Daus Mahnke, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.


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