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Bachelor of Medicine and Surgery MBChB (UCT).
Fellow of South African College of Surgeons
Diploma in Obstetrics & Gynaecology
Gastrectomy: A Patient's Guide
What is a Gastrectomy?
A gastrectomy is a major surgical procedure to remove all or part of the stomach. The type of gastrectomy performed depends on the underlying condition and the extent of the disease. There are two main types:
Partial Gastrectomy: The surgeon removes only a portion of the stomach. The remaining part of the stomach is then reconnected to the small intestine.- Total Gastrectomy: The entire stomach is removed. The oesophagus is then directly connected to the small intestine.
After the stomach is removed, your digestive system is reconstructed to allow food to pass from the oesophagus to the small intestine, although you will need to make changes to how and what you eat.
Indications: When is this procedure recommended?
A gastrectomy is most commonly performed to treat stomach cancer. However, it may also be recommended for other serious conditions that have not responded to less invasive treatments. Indications for a gastrectomy can include:
- Stomach Cancer: This is the most frequent reason for a gastrectomy. The surgery is performed to remove the cancerous part of the stomach and surrounding lymph nodes to cure the disease or prevent it from spreading.
- Severe Peptic Ulcers: In rare cases, a gastrectomy may be necessary for peptic ulcers that have led to complications like severe bleeding, perforation (a hole in the stomach wall), or obstruction.
- Benign Tumours: Non-cancerous tumours in the stomach that are large, causing symptoms, or have the potential to become cancerous may require removal.
- Gastritis: In very rare cases, a gastrectomy may be a last resort for severe gastritis (inflammation of the stomach lining) that has not improved with medication.
The Procedure: What to expect
- Preparation: Before the surgery, your doctor will give you specific instructions. You may need to have several diagnostic tests, and you will need to fast (not eat or drink) for a certain number of hours before the procedure.
- Anaesthesia: The surgery is performed under general anaesthesia, meaning you will be asleep and will not feel any pain.
- Surgical Approach: A gastrectomy can be performed using either an "open" or "laparoscopic" approach:
- Open Surgery: The surgeon makes a single large incision in your abdomen to access and remove the stomach.
- Laparoscopic Surgery: The surgeon makes several small incisions in your abdomen. A laparoscope (a thin tube with a camera) and other surgical instruments are inserted through these incisions. This "minimally invasive" approach often results in less pain and a faster recovery.
- Removing the Stomach: The surgeon will carefully remove the diseased portion of the stomach (partial gastrectomy) or the entire stomach (total gastrectomy). Lymph nodes and other tissues may also be removed, especially in cases of cancer.
- Reconstruction: The surgeon will reconstruct your digestive tract. This involves reconnecting the remaining parts of your digestive system so that you can continue to eat and digest food. For example, in a partial gastrectomy, the remaining stomach is reattached to the small intestine. In a total gastrectomy, the oesophagus is connected directly to the small intestine.
- Closure: The incisions are closed with sutures or surgical staples.
Recovery
A gastrectomy is a major surgery that requires a hospital stay, typically for 1 to 2 weeks.
- Initial Recovery: You will be monitored closely in the hospital. You may have several tubes, such as a nasogastric tube (a tube through your nose to your stomach) or a catheter, which will be removed as you recover.
- Diet: You will not be able to eat or drink immediately after surgery. You may receive fluids and nutrition through an IV or a temporary feeding tube. Your care team will guide you through a gradual transition from liquids to soft foods over several weeks or months. You will need to learn to eat smaller, more frequent meals.
- Activity: Recovery at home will take several weeks. You will need to avoid heavy lifting and strenuous activity to allow your body to heal. Your doctor will provide a detailed plan for your return to normal activities.
Risks and Complications
Like any major surgical procedure, a gastrectomy has potential risks and complications, which will be discussed in detail with your surgeon. These can include, but are not limited to:
- Infection or bleeding
- Leakage from the surgical connections
- Obstruction or narrowing of the digestive tract
- "Dumping syndrome," a condition where food moves too quickly from the stomach to the small intestine, causing symptoms like nausea, cramping, and light-headedness.
- Long-term nutritional deficiencies (e.g., anaemia, vitamin B12 deficiency) because of the loss of the stomach's digestive function.
Please note: The information provided above and on this website is for education and interest purposes only. It is not intended to replace a personal one-on-one consultation, nor is it meant to substitute professional medical advice, diagnose or treat any condition. A consultation with a specialist and qualified health care provider such as Dr. Mitchell or Dr. Munda is essential for correct diagnosis and management, as well as to answer any queries that you may have. Never disregard or delay in seeking professional medical advice due to something you have read on this website. Dr. Mitchell and Dr. Munda take no responsibility for any errors or omissions present on this website and they are not liable for any consequences that may occur from misinterpretation of the information on this website. In the event of uncertainty or an emergency, please visit your nearest casualty.