Gastrectomy

A gastrectomy is a medical procedure where all or part of the stomach is surgically removed.

There are four types of gastrectomy:

• total gastrectomy – the whole stomach is removed
• partial gastrectomy – the lower part of the stomach is removed
• sleeve gastrectomy – the left side of the stomach is removed
• oesophagogastrectomy – the top part of the stomach and part of the oesophagus (gullet) is removed

The stomach is connected to the gullet (oesophagus) at its top and the first sections of the duodenum (small intestine) at its bottom. During the operation, the surgeon connects the oesophagus either to the small intestine or the remaining section of stomach. This means that you'll still have a working digestive system, although it won't function as well as it did before.

Read more about how a gastrectomy is performed.

Why is a gastrectomy carried out?

A gastrectomy is often used to treat stomach cancer.

Less commonly, it's used to treat:

• life-threatening obesity
• oesophageal cancer
• stomach ulcers (peptic ulcers)
• non-cancerous tumours

Read more about why a gastrectomy is used.

After a gastrectomy

A gastrectomy is a major operation, so recovery can take a long time. You'll usually have to stay in hospital for one or two weeks after the procedure, where you may receive nutrition into a vein until you can eat and drink again.

You'll eventually be able to digest most foods and liquids. However, you may need to make changes to your diet, such as eating frequent, smaller meals rather than three large meals a day. You may also need vitamin supplements to ensure you're getting the correct nutrition.

In many cases, a gastrectomy is an effective operation. Studies show that survival rates for cancer after a gastrectomy are generally good. It's also been proven that people who have the operation to treat obesity lose a significant amount of weight afterwards.

Read more about recovering from a gastrectomy.

Results

Gastrectomy is usually an effective treatment for cancer and obesity.

Cancer

Healthcare professionals use the phrase "five-year disease-free survival" to refer to people who are alive and well, and whose cancer hasn't returned five years after having surgery.

• The five-year disease-free survival rate for people who have a gastrectomy for early-stage stomach cancer is estimated to be up to 90%.
• The five-year disease-free survival rate for people who have a gastrectomy for advanced stomach cancer is estimated to be around 25%.

However, many people who have a gastrectomy for stomach cancer live for much longer than five years without the cancer returning.

The survival rate of oesophagogastrectomy to treat cancer isn't as good. Studies have shown five-year disease-free survival rates of around 25% for this type of operation. This may be because this operation is usually done if the cancer is discovered at a late stage and has already started to spread.

Obesity

Sleeve gastrectomy has a good success rate for treating obesity.

Studies have found excess weight loss of up to 75% after surgery. Excess weight loss is a measurement based on your weight before surgery and your ideal weight.

Further research is needed to determine how effective sleeve gastrectomy is for the long-term treatment of obesity. Studies often show that average excess weight declines over time, which suggests that some people regain some of the weight they initially lost.

To get the best results from a sleeve gastrectomy, it's important to follow the instructions given by your healthcare team about diet and exercise.

Complications

As with any type of surgery, a gastrectomy carries a risk of complications, such as infection, bleeding and leaking from the area that's been stitched together.

A gastrectomy may also lead to problems caused by a reduction in your ability to absorb vitamins, such as anaemia and osteoporosis. 

Read more about the possible complications of a gastrectomy.