What is a gastrectomy?
Gastrectomy is surgery to remove part or all of your stomach. The stomach is an important organ used for digestion. It is located in the upper part of your belly. Food and liquid pass from your esophagus into your stomach. There it mixes with digestive juices to break down the food.
Your surgeon may do this surgery to treat diseases of your stomach, such as cancer. It is also done to treat severe obesity. There are several types of gastrectomy. Total gastrectomy removes the whole stomach. Partial gastrectomy removes only a portion of the stomach.
Your surgeon will usually do this surgery in the hospital and you will be asleep (general anesthesia). Your surgeon will use one of two techniques. One uses one large incision, called open surgery. The other involves making several small incisions and a laparoscope. This is a special telescope and long, thin operating instruments.
Why might I need a gastrectomy?
Gastrectomy is the main treatment for stomach cancer. Other reasons for this surgery include:
- Noncancerous growths of the stomach
- Bleeding from the stomach
- Stomach ulcers
- Severe obesity
What are the risks for a gastrectomy?
Any time you have general anesthesia, there is a small risk of damaging your heart, lungs, or brain. Removing your stomach may decrease your ability to digest and absorb important nutrients in your diet. This can lead to vitamin deficiencies, anemia, and weak bones. Other risks include:
- Blood clots
- Leaking of stomach contents
- Stomach pain after eating
Depending on your condition, there may be other risks. Discuss any concerns with your doctor before the procedure.
How do I prepare for a gastrectomy?
- Your doctor will explain the procedure and ask if you have any questions.
- You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
- In addition to a complete medical history, your doctor may do a physical exam to ensure you are in good health before undergoing the procedure. You may have blood or other tests.
- You will be asked not to eat or drink anything for 8 hours before the procedure, generally after midnight.
- If you are pregnant or think you may be, tell your healthcare provider.
- Tell your doctor if you are sensitive to or are allergic to any medicines, iodine, latex, tape, and local and general anesthesia (anesthetic agents).
- Tell your doctor of all medicines and herbal supplements that you are taking. This includes both prescribed and over-the-counter.
- Tell your doctor if you have a history of bleeding disorders. Also, tell your doctor if you are taking any blood-thinning (anticoagulant) medicines, aspirin, or other medicines that affect blood clotting. It may be necessary for you to stop these medicines prior to the procedure.
- Based on your medical condition, your doctor may request other specific preparation.
What happens during a gastrectomy?
A gastrectomy is done while you are asleep under general anesthesia. However, your doctor will determine the type of anesthesia based on the reason for the procedure and your overall health status. Generally, a gastrectomy starts with this process:
- You will be asked to remove any jewelry or other objects that may interfere with the procedure.
- You will be asked to remove clothing and be given a gown to wear.
- An IV line will be inserted in your arm or hand.
- A catheter may be inserted into the bladder to reduce the risk of tearing a hole in the bladder.
- You will lie on your back on the operating table.
- The anesthesiologist will monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery.
- If there is excessive hair at the surgical site, it may be shaved off.
- The skin over the surgical site will be cleaned with an antiseptic solution.
The rest of the procedure will depend on the type of gastrectomy to be done:
- Total gastrectomy. Your surgeon will make an incision in your upper abdomen and remove your stomach. Next, he or she will attach your esophagus to the upper part of your small intestine. If your surgeon is doing a total gastrectomy for stomach cancer, he or she may remove lymph nodes around your stomach.
- For partial gastrectomy. Your surgeon will do this procedure if only part of your stomach needs to be removed. He or she will make an incision that is similar to that of a total gastrectomy. He or she will attach the upper part of your stomach to the small intestine, with the location determined by the type of surgery. If you have cancer, your surgeon may also remove lymph nodes.
- For laparoscopic gastrectomy. Your surgeon may use this for either total or partial gastrectomy. He or she will remove your stomach through several small incisions, just big enough for the thin surgical instruments to pass through. Laparoscopic surgery may not be used for advanced stomach cancer.
What happens after a gastrectomy?
After gastrectomy, you will stay in the hospital for several days. You will most likely have a tube that runs through your nose and into your stomach. It will help to remove liquids and air. The tube will be removed once gas and fluids start moving through your digestive system. An IV tube will remain in your vein. This will provide you with fluids and nutrition until you can start eating. You will be given pain medicine, along with other medicines, depending on your condition. Hospital staff will help you walk, and provide wound care and bathroom care.
After you go home, follow all your healthcare provider’s instructions and keep your follow-up appointments. Instructions for home care may include:
- Limit activity until your doctor says it’s OK.
- Eat smaller, more frequent meals.
- Take vitamin supplements.
- Watch your incision for any signs of redness, swelling, bleeding, or leaking.
Complete recovery after gastrectomy may take several weeks.
Tips to help you get the most from a visit to your healthcare provider:
- Know the reason for your visit and what you want to happen.
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your healthcare provider tells you.
- At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your healthcare provider gives you.
- Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
- Ask if your condition can be treated in other ways.
- Know why a test or procedure is recommended and what the results could mean.
- Know what to expect if you do not take the medicine or have the test or procedure.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your healthcare provider if you have questions.
April 03, 2017
Partial gastrectomy and gastrointestinal reconstruction. UpToDate.
Lehrer, Jenifer, MD,Taylor, Wanda, RN, Ph.D.