What is a gastrectomy?
A gastrectomy is the surgical removal of the entire stomach. This distinguishes gastrectomy from gastric resection or partial gastric resection, as these procedures still leave a residual stomach. However, these procedures are only suitable for benign cancers.
Replacement of the stomach after gastrectomy
When do you perform a gastrectomy?
Gastrectomy is mainly performed for malignant stomach cancer. Complete removal is necessary to ensure that no cancer cells remain in the body. Otherwise, there is a possibility that the cancer will continue to grow despite the surgery. For benign tumors, gastric resection is usually sufficient, in which only part of the organ is removed.
A special operation is the so-called sleeve gastrectomy. Unlike the name suggests, the surgeon removes a large part of the stomach and sews the rest into a tube. This sleeve stomach holds significantly less food and is therefore used as one of the last treatment options for severely overweight people.
What is done during a gastrectomy?
To begin, the surgeon cleans the skin with a disinfectant and covers it with sterile drapes. He then opens the abdomen with a central longitudinal incision to gain access to the stomach. In principle, however, a gastrectomy can also be performed as part of an abdominal endoscopy. Here, the surgeon inserts the so-called trocars into the abdomen through several small incisions, with which he remotely performs the gastrectomy.
Connecting the esophagus and intestine
In order for the patient to be able to digest food again after the stomach has been removed, the surgeon must connect the adjacent organs. There are several options for this:
- Sewing in another piece of small intestine between the esophagus and duodenum.
- Reservoir formation by sewing in two adjacent pieces of small intestine
- Suturing of a more distant piece of small intestine to the esophagus and closure of the blind-ended duodenum
Gastrectomy is a very major surgery. Accordingly, there are many possible complications:
- Injury to neighboring organs, for example, the liver, pancreas, or small intestine.
- Bleeding due to injury to blood vessels
- severing of nerves resulting in functional disorders of the intestine
- Infections and formation of encapsulated pus accumulations (abscesses)
- Lack of tightness of sutures in the area of the intestine
- Pancreatitis or bile duct inflammation
- Esophagitis (heartburn) due to refluxing bile juice
- Wound healing disorders
- Scar fractures of the abdominal skin
What should I be aware of after a gastrectomy?
After the operation, you should watch out for pain, nausea, dizziness and digestive complaints such as diarrhea or constipation and report the occurrence of these complaints to your surgeon immediately. To prevent dumping syndrome after gastrectomy, it is also important to avoid eating large meals. Instead, eat six to eight small portions throughout the day.
