A gastrectomy is the surgical removal of part or all of your stomach. Depending on how much of the stomach needs to be removed, the surgeon can reconnect your digestive tract so you can eat and drink.
At AHN, gastrectomy surgeries are typically performed to treat stomach cancer, but can also be used for severe ulcers, polyps, or other conditions.
The most common reason to undergo a gastrectomy is for stomach cancer. In almost all cases of gastric cancer, the surgeon will also remove nearby lymph nodes to check for cancer spread (lymph node dissection).
Other reasons for gastrectomy include:
The amount of stomach removed depends on the reason for the surgery. It could be a small portion, a larger section, or the entire stomach:
The parts of your gastric system that are affected by your condition will determine the type of gastrectomy you may receive. The surgery alters the normal flow of digestion. The stomach's role in storing, mixing, and slowly releasing food is either reduced (partial gastrectomy) or eliminated (total gastrectomy). This puts more responsibility on the esophagus and small and large intestines to manage the digestive process, which can lead to complications like dumping syndrome and nutritional deficiencies.
Your esophagus, small intestine, and bowels can also be affected by a gastrectomy. Your AHN surgical team will work to achieve minimal side effects, but the following can occur in the different parts of the body:
A common complication following gastrectomy is dumping syndrome. This occurs when food, especially sugary items, moves too quickly from the stomach (or what remains of it) into the small intestine. This rapid dumping can cause a variety of symptoms, including nausea, vomiting, diarrhea, abdominal cramps, dizziness, and rapid heartbeat, usually occurring shortly after eating (early dumping) or one to three hours later (late dumping).
AHN's nutrition team provides personalized dietary guidance before and after surgery to help avoid this issue. Our registered dietitians work closely with patients to develop strategies such as eating smaller, more frequent meals, limiting sugary foods, and adjusting the timing and composition of meals to minimize the risk of dumping syndrome and optimize nutrient absorption.
At AHN, we are committed to providing the highest quality care and improving outcomes for patients with gastrointestinal disorders. Our Esophageal and Gastric Cancer Center of Excellence is one of a few dedicated comprehensive foregut centers in the United States. Our institute provides patients with diagnoses, innovative treatments, and access to first-in-class clinical trials including:
Before a gastrectomy, your AHN surgical team will give you detailed instructions on how to prepare. You will be able to ask any questions and will be given the information you need to feel confident in your surgical plan. Generally, before surgery, you will undergo a comprehensive evaluation that includes a physical exam, blood tests, and a review of your medical history. You likely will have imaging tests done to evaluate the extent of the disease and to plan the surgical approach. You may have an endoscopy that will visualize the inside of your stomach and take any additional biopsies for further analysis.
You will be given personalized preoperative instructions from your AHN team. Most often, before surgery, you may expect:
On the day of your gastrectomy surgery, you will arrive at the hospital and go through your preoperative preparation. This usually includes meeting with your care team to discuss the surgery, having an IV inserted for fluids and medications, and eventually receiving anesthesia. The surgeon will perform the gastrectomy, which may involve removing part or all of the stomach. The specific technique used depends on the extent and location of the cancer, as well as the surgeon's preference. The surgeon will reconnect the remaining digestive tract to allow for the passage of food. This may involve connecting the esophagus to the small intestine (in a total gastrectomy) or connecting the remaining portion of the stomach to the small intestine (in a partial gastrectomy). The duration of a gastrectomy can vary depending on the complexity of the case and the surgical technique used. It typically takes between three to six hours.
Following a gastrectomy, patients typically spend several days to a week or more in the hospital for monitoring and pain management. Typically, patients resume their diet with liquids and eventually progress to more solid foods over a period of days to weeks. In the first several weeks after surgery, there may be fatigue and discomfort. Adherence to the post-surgical guidelines provided by your team is crucial to prevent complications and improve recovery. Full recovery can take several weeks to months, with ongoing adjustments to diet and lifestyle to optimize digestion and nutrient absorption.
Since a gastrectomy is a major surgery, you will likely have questions and, possibly, concerns. That is completely normal and expected. Your AHN care team is here to help and will be with you throughout the entire process. They are able to answer your questions and talk with you about any concerns you may have. To help you get started, we’ve included some frequently asked questions that can give you background information and help you collect your thoughts and questions prior to meeting with your surgical team.
Life expectancy after a gastrectomy is highly variable and depends on several factors, including the reason for the surgery (e.g., cancer, benign condition), the stage of the disease (if cancer-related), the patient's overall health, and their response to treatment. For gastrectomy performed due to cancer, the stage of the cancer is a key factor influencing survival. Patients with early-stage cancer who undergo complete surgical removal may have a significantly better prognosis than those with advanced-stage cancer. Overall, life expectancy can range from several years to a normal lifespan, depending on the individual's circumstances. It's crucial to discuss the specific prognosis with the patient's oncologist, who can provide a more personalized estimate.
After a partial gastrectomy (removal of part of the stomach), the remaining portion of the stomach is connected to the small intestine. After a total gastrectomy (removal of the entire stomach), the esophagus is directly connected to the small intestine, usually to the jejunum. This creates a new pathway for food to travel through the digestive system, bypassing the stomach's usual functions of food storage, mixing, and initial digestion. Sometimes, the surgeon will create a small pouch from a section of the small intestine to act as a reservoir, mimicking some of the stomach's storage function.
Yes, you can still eat if your stomach is removed, but dietary modifications are necessary. Since the stomach's role in food storage and initial digestion is lost, patients need to eat smaller, more frequent meals throughout the day. The diet typically focuses on easily digestible foods. A common dietary progression after a gastrectomy starts with liquids, then moves to soft foods, and eventually to solid foods as tolerated. Foods that are high in sugar or fat may need to be limited or avoided, as they can trigger dumping syndrome. It is very important to work with a registered dietitian to develop a personalized meal plan that ensures adequate nutrition and minimizes digestive problems.
Yes, it is still possible to throw up (vomit) even after the stomach is removed, although it might be less frequent. Without the stomach, there is no reservoir to hold a large volume of food, so vomiting may occur if the small intestine becomes overloaded or irritated. Vomiting can be caused by various factors, such as eating too much too quickly, consuming foods that are difficult to digest, or experiencing a blockage in the small intestine. If vomiting becomes frequent or severe, it's important to seek medical attention to rule out any underlying complications.
Please call:
