How is a partial gastrectomy performed?

A partial gastrectomy is usually performed with the patient under general anesthesia by a gastrointestinal surgeon. The surgery is performed in an operation theater, and may take up to five hours.
Preparation
Prior to a partial gastrectomy, a patient may be required to
- Undergo urine, blood and imaging tests.
- Undergo corrective treatment for any existing conditions that preclude surgery.
- Undergo an upper gastrointestinal endoscopy.
The patient must
- Avoid eating or drinking for 8 hours prior to the surgery.
- Check with the doctor before taking any regular medications.
- Inform the doctor of any allergies.
- Empty the bladder and bowel.
Procedure
- The patient has an IV line attached for administration of medications and fluids.
- An anesthesiologist administers anesthesia and monitors the patient’s vital functions during the procedure.
- The patient is intubated to provide oxygen.
- The surgeon
- Inserts a nasogastric tube to decompress the stomach.
- Performs a gastric lavage (stomach pumping) to remove residual gastric content.
- Makes one or more incisions in the abdomen depending on the type of surgery.
- Introduces carbon dioxide into the abdomen in case of a laparoscopic surgery.
- Finds, excises and removes the diseased part of the stomach.
- May also remove other parts of the gastrointestinal tract if there is presence of cancer.
- May remove other organs such as spleen or pancreas, if there are visible signs of cancer.
- Removes adjacent lymph nodes to prevent metastasis.
- Connects the remaining portion of the stomach to the duodenum or jejunum, with staples or sutures.
- Rinses the abdominal cavity with saline (lavage).
- Places a surgical drain and closes the incisions with sutures.
Post-procedure
- The patient is brought out of anesthesia and administered painkillers for post-surgical pain.
- The patient will be monitored in the recovery room for several hours until vital functions are stable.
- People with malignancies and comorbid conditions are likely to require continued treatment.
How long does it take to recover from a partial gastrectomy?
A partial gastrectomy may require hospitalization of up to 2 weeks, or less, if the procedure is laparoscopic. The patient may require feeding through a tube inserted into the small intestine and fluids through an IV line during the recovery period in the hospital.
The patient may be able to eat normally after the surgical wound heals, but may have to be on a special diet and avoid spicy, fatty or sugary foods. Without complications, full recovery can be expected in 6 weeks, during which period the patient must avoid heavy lifting and strenuous activities.
What are the side effects of a partial gastrectomy?
The side effects of a partial gastrectomy include
- Anesthetic side effects such as
- Abdominal pain from the surgery
- Impaired digestion that may lead to
- Gas and bloating
- Nausea and vomiting
- Constipation and/or diarrhea
- Bile reflux
- Drop in sugar levels
- Fatigue
- Weight loss
- Need for lifelong changes in eating habits and lifestyle
- Need for supplemental minerals and vitamins

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