Stomach Surgery

Gastrectomy is the surgical removal of all or part of the stomach and reconnection to the small intestine. This surgery used to treat stomach cancer, noncancerous polyps, gastric ulcers, or a hole in the stomach wall. The surgery is performed under general anesthesia and usually involves a seven to ten day hospital stay. If combined with other procedures, the stay can be lengthy.

If the patient has a severe duodenal ulcer (on the first part of the small intestine) the lower portion of the stomach (called the pylorus) and the upper part of the small intestine (called the duodenum) may have to be removed. Sometimes the stomach cannot be reattached to the small intestine at the same area. In that case the duodenum is sealed off and the stomach is attached to the jejunum (the next section of the small intestine). That procedure is called a Billroth II. If this is done, patients often experience gasrtic dumping syndrome, because of the food moving at a faster speed through the small intestine.

Common reasons why a gastrectomy is performed is to treat severe cases of peptic ulcer disease, perforations of the stomach wall and cancer. Less severe peptic ulcers are more often treated with antibiotics, so the surgery is not always recommended for that. If there is a cancerous tumor, the surgery is done to remove the tumor and in some cases a portion of the stomach. Sometimes parts of the digestive system are reconstructed so that the body continues to function normally.

Prior to a gastrectomy, the patient has to undergo various tests and scans including x-rays and ultrasonography. If a growth or tumor is present, a laparoscopy may be done to test for malignance.

This surgery is effective, but it may result in a variety of probable complications. Following gastrectomy surgery, about 30% of patients have significant symptoms. An operation called highly selective vagotomy is now preferred for ulcer management, and is safer than gastrectomy.

After a gastrectomy, several abnormalities may develop that produce symptoms related to food intake. They happen mainly because the stomach has been reduced in its capacity by the surgery. Patients may have to eat less. These procedures to help these complications include vagotomy, which lessens acid production and slows stomach emptying; and pyloroplasty, which enlarges the opening between the stomach and small intestine to assist the emptying of the stomach. There is a 1-3% chance the patient may not survive post-surgery if the operation was extensive.