Gastrectomy

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

Pronounced: gas-TREK-tuh-mee
by Krisha McCoy, MS

Definition

This is a surgery to remove all or part of the stomach.

Abdominal Organs, Anterior View

gastro intestinal stomach
Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

Gastrectomy is most often done to treat stomach cancer. It is currently the only way to cure stomach cancer. The use of chemotherapy and radiation may help improve survival. Even if the cancer is too advanced to be cured, gastrectomy can help to prevent bleeding, obstruction, and pain.

In addition to treating stomach cancer, this surgery may also be done to treat:

  • Ulcer disease
  • Bleeding
  • Inflammation
  • Benign tumors in the stomach

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

  • Damage to nearby organs
  • Leaking from the new connection between the stomach, intestine, and/or esophagus
  • Infection
  • Bleeding
  • Hernia formation at the incision site
  • Blood clots
  • Reaction to anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

Your doctor may do the following:

  • Physical exam
  • Blood tests
  • Fecal occult blood test (FOBT)—a test to check for blood in the stool
  • Upper GI endoscopy —use of a tube attached to a viewing device called an endoscope to examine the inside of the lining of the esophagus and stomach (a biopsy may also be taken)
  • Imaging studies to look at the esophagus, stomach, and intestine, including:

Leading up to your procedure:

  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
  • Your doctor may recommend:
    • Eating a special diet
    • Taking antibiotics
    • Showering the night before your surgery using antibacterial soap
  • Arrange to have someone drive you to and from the hospital. Also, arrange for someone to help you at home.
  • Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

An incision will be made in the abdomen. Surgical instruments will be used to remove all or part of the stomach. If only part of the stomach is removed, it is called partial gastrectomy. With this type of surgery, the remaining part of the stomach will be connected to the esophagus and small intestine. If this is done for ulcer disease, the nerves that control acid production may also be cut. If all of the stomach is removed, it is called total gastrectomy. A new stomach will be made using the intestinal tissue. The end of the esophagus will be attached to the small intestine.

If you have stomach cancer, the lymph nodes will be removed and examined as well. This is because cancer can spread through the lymphatic system.

After the surgery is complete, the muscles and skin of the abdomen will be closed with stitches or staples. A dressing will be applied.

How Long Will It Take?

1-3 hours or longer

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

This surgery is done in a hospital setting. The usual length of stay is 6-12 days. Your doctor may choose to keep you longer if complications arise.

Post-procedure Care

At the Hospital

Your doctor will give you guidelines on:

  • When and what you can eat
  • 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 recovery, you will be able to eat more a little at a time. If you had a total gastrectomy, you will need to eat smaller amounts of foods more often.

After surgery, you may experience:

  • Frequent heartburn
  • Abdominal pain
  • Vitamin deficiencies

To treat these symptoms, your doctor will:

  • Prescribe medications and vitamin supplements
  • Recommend medications to reduce stomach acid
  • Make changes in your diet

Your bowels will work more slowly than usual. Chewing gum may help speed the process of your bowel function returning to normal.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to reduce your chance of infection such as:

  • Washing your hands often and reminding visitors and healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision

Call Your Doctor

Call your doctor if any of these occur:

  • Signs of infection, including fever and chills
  • Diarrhea
  • Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
  • Persistent nausea or vomiting
  • Pain that you cannot control with the medications you were
  • Pain or swelling in your feet, calves, or legs
  • Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
  • Cough, shortness of breath, or chest pain

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

National Cancer Institute
https://www.cancer.gov
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Cancer Society
https://www.cancer.ca
Provincial Health Services Authority
http://www.bccancer.bc.ca

References:

Gastric carcinoma. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116155/Gastric-carcinoma . Updated December 12, 2017. Accessed January 10, 2018.
Short V, Herbert G, Perry R, et al. Chewing gum for postoperative recovery of gastrointestinal function. Cochrane Database Syst Rev. 2015;2:CD006506.
Stomach cancer Cancer Research UK website. Available at:
...(Click grey area to select URL)
Updated July 6, 2016. Accessed January 10, 2018.
Surgery for stomach cancer. American Cancer Society website. Available at: https://www.cancer.org/cancer/stomach-cancer/treating/types-of-surgery.html. Updated December 15, 2017. Accessed January 10, 2018.
Treatment option overview. National Cancer Institute website. Available at: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq#section/_50. Updated April 27, 2017. Accessed January 10, 2018.
Last reviewed November 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 03/23/2015

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