A gastrectomy is a surgical procedure to remove part or all of the stomach.

Doctors may recommend gastrectomy as a treatment for stomach cancer, which is also called gastric cancer. The procedure can also treat diabetes, gastroparesis, and obesity.

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After surgery, a person will digest foods differently, but they will still be able to eat and drink. It may take some time to recover and get used to a new diet and way of eating.

In this article, we look at the uses of gastrectomy, what to expect before, during, and after the procedure, and possible complications.

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Types of gastrectomy

Surgeons performing gastrectomy in operating theatre.
A gastrectomy involves removing all or part of the stomach.

There are three main types of gastrectomy:

  • complete gastrectomy, in which the whole stomach is removed
  • partial gastrectomy, in which part of the stomach is removed
  • sleeve gastrectomy, in which part of the left side of the stomach is removed to reduce the organ’s size

The procedure will vary, depending on the health issue and personal factors.

When is gastrectomy used?

A doctor may recommend gastrectomy to treat the following conditions:

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Gastric cancer

Doctors usually recommend gastrectomy to treat stomach cancer in people who are sufficiently healthy. The surgeon will leave as much stomach as possible, which will vary, depending on the type and stage of cancer.

The effectiveness of the surgery depends on the stage of cancer at diagnosis. To ensure the best results, a treatment plan may include a gastrectomy and concurrent chemotherapy, chemoradiotherapy, or perioperative chemotherapy.

Gastroparesis

Doctors may consider using a partial or total gastrectomy to treat gastroparesis, but rarely, and only in carefully selected patients. Researchers must conduct further studies before this becomes a commonplace treatment.

Obesity

Doctors can use gastrectomy to treat obesity, but they only consider it in rare cases when other methods, such as diet, exercise, and designated drugs, have not been effective. The medical community considers the procedure to be safe and highly effective in treating obesity.

Diabetes

According to a 2016 review, gastrectomy may also improve the outcome for people with type 2 diabetes.

Authors of a 2015 review found that gastric bypass surgery and sleeve gastrectomy were both effective in managing diabetes and obesity.

Procedure

Surgeons can perform stomach surgeries in two ways:

  • Open surgery is common, and it involves a surgeon removing the stomach from an incision in the abdomen.
  • Laparoscopic (keyhole) surgery involves making several small incisions in the area. Because this type of surgery is minimally invasive, it often leads to quicker recovery times and fewer risks than open surgery.

After a surgeon removes a section of the stomach, they reconstruct the gastric tract. Often, they use a Y-shaped device called a Roux limb to reconnect parts of the digestive system.

How to prepare for a gastrectomy

Woman having blood sample taken for testing.
A doctor will often request a blood test before a gastrectomy.

Before the procedure, a person may need to restrict the diet, by fasting or avoiding certain foods.

A doctor may also recommend not taking some medications or supplements. Always follow the doctor’s instructions.

A person may feel more comfortable thinking about the surgery if are knowledgeable about what will happen. It may be a good idea to discuss the surgery and recovery in detail with the doctor.

Before a gastrectomy, a doctor usually performs routine tests, such as:

  • blood tests
  • urine tests
  • an electrocardiogram
  • a chest X-ray

They may perform additional tests to better understand the person’s condition. These may include:

What to expect after the procedure

A person can often consume any food or drink that does not cause discomfort unless a nurse or doctor tells them otherwise.

Speak with a doctor about which foods can be problematic. If some cause discomfort or loose bowel movements, remove them from the diet and reintroduce them after a few weeks.

Below are more tips for a quicker recovery:

Exercise. Keep moving, even in bed, to avoid problems like blood clots and muscle weakness. Rotate the feet, stretch the legs, and wiggle the toes to increase blood circulation and maintain muscle strength

Deep breathing. Lying in bed for long periods can lead to pneumonia. Deep breathing techniques can prevent this type of complication. After surgery, a doctor may give a person an inspirometer, which is a device designed to help with deep breathing.

Pain control. Communicate pain levels to medical staff. Managing pain successfully will help a person return to regular activities more quickly.

Avoid certain activities. Limit the amount of bathing and swimming, heavy lifting, and driving until a doctor recommends resuming them fully.

Typically, a medical professional removes stitches or clips within 7–10 days of surgery. After this, a person can slowly begin to return to regular activities.

Life after gastrectomy

Person helping themselves to various foods from a buffet.
Certain foods may be harder to digest after gastric surgery.

After gastric surgery, a person often has to change their diet, because their stomach is smaller and may be less able to handle certain foods. Many people report being able to eat less, feeling full sooner, and having some digestive complications.

Speak with a doctor about the best foods to eat or avoid after surgery.

Some people experience nutritional deficiencies after gastrectomies. Medical professionals should monitor a person’s levels of:

The organization No Stomach for Cancer provides useful information for those who have had gastric surgery. See their blog for stories about living a full life after a gastrectomy.

Complications and side effects of surgery

According to No Stomach for Cancer, up to 75 percent of people who have had partial or total gastrectomies experience dumping syndrome, which occurs when food passes too quickly into the intestines.

Other complications of a gastrectomy can include:

A person may also have difficulties getting enough nutrients. This can result in anemia, poor bone metabolism from a lack of calcium and vitamin D, and weight loss, potentially from poor absorption of micronutrients.

If a person feels any of the following symptoms after a gastrectomy, they should contact a doctor:

  • warmth or redness around the site of surgery
  • pus coming from the site
  • a fever of over 100.4ºF or 38ºC
  • inability to drink or keep down liquids
  • pain that is not improved by medication

Outlook

A total or partial gastrectomy is an effective treatment for stomach cancer. It can also treat obesity.

Talk to a doctor about what to expect before, during, and after a gastrectomy.

Recovering from this surgery can take some time, but with the support of a medical team, most people go on to make a full recovery and lead regular lives.