Gastrectomy surgery - definition and complications

Gastrectomy surgery - definition and complications

Partial or complete surgical removal of the STOMACH, typically to treat STOMACH CANCER or uncontrollable bleeding resulting from PEPTIC ULCER DISEASE. Gastrectomy is a major OPERATION, typically an OPEN SURGERY, performed under general ANESTHESIA that requires several days to a week in the hospital and 8 to 12 weeks for total recovery and return to regular activities. An individual’s course of recovery depends on the reasons for the surgery. The surgical operation takes two to three hours. After removing the diseased portion of the stomach through an abdominal incision at the lower edge of the left rib cage, the surgeon connects the remaining portion of the stomach (or the ESOPHAGUS, when the gastrectomy is total) to the DUODENUM. A partial (also called subtotal) gastrectomy leaves a gastric pouch that can carry on some of the digestive functions of the stomach. Total gastrectomy, which is less common, leaves no residual gastric pouch though the surgeon may construct one by expanding a portion of the duodenum.

Many people are able to return to normal eating habits after they recover from the surgery, though find that they need to eat frequent small meals to accommodate the smaller stomach and reduce gastrointestinal distress. Foods that are high in protein and low in simple sugars are easier for the small intestine to digest without the aid of the stomach. Some people have difficulty eating regular foods after gastrectomy and need to use NUTRITIONAL SUPPLEMENTS, typically liquid preparations, to meet their NUTRITIONAL NEEDS.

Risks and Complications of Gastrectomy surgery

Risks and complications of gastrectomy include bleeding, INFECTION, dumping syndrome (RAPID GASTRIC EMPTYING), and damage to the vagus NERVE (which regulates gastric PERISTALSIS and other digestive functions). People who have total gastrectomies, and many people who have subtotal gastrectomies, need regular injections of vitamin B12 (cyanocobalamin) because the gastric mucosa is no longer able to produce intrinsic factor, a chemical substance that allows the SMALL INTESTINE to absorb this vital nutrient. Vitamin B12 deficiency causes pernicious ANEMIA.

See also BARIATRIC SURGERY; CANCER TREATMENT OPTIONS AND DECISIONS; CRANIAL NERVES; SURGERY BENEFIT AND RISK ASSESSMENT.

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The Gastrointestinal System

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