Gastrectomy is a type of major surgery to remove part or all of the stomach. Surgeons most commonly perform the procedure to treat stomach cancer.
The amount or part of the stomach surgeons remove depends on the type and severity of the condition. The surgeon may perform it as either laparoscopic or open surgery.
Read on to learn more about the purpose and types of gastrectomy. This article also looks at preparing for the surgery, what to expect from recovery, and more.
The purpose of gastrectomy is to remove part or all of the stomach, most commonly to remove the tumor in the treatment of stomach cancer.
In some cases, a doctor may recommend gastrectomy to treat esophageal cancer or cancer that develops where the stomach meets the esophagus. If the surgeon removes part of the stomach and esophagus, this is called esophagogastrectomy.
Other conditions gastrectomy can treat include:
- stomach ulcers
- noncancerous tumors
- obesity
Learn more about stomach cancer surgery.
There are several types of gastrectomy:
- partial gastrectomy
- total gastrectomy
- esophagogastrectomy
- sleeve gastrectomy
Partial gastrectomy
Partial gastrectomy, also called subtotal gastrectomy, involves removing up to two-thirds of the stomach. The surgeon will also remove part of the omentum, which is a tissue layer that helps hold the stomach together.
The surgeon will remove the part of the stomach where the tumor or ulcer has grown.
Total gastrectomy
Total gastrectomy involves removing the entire stomach and omentum. This may be necessary if the cancer develops in the middle of the stomach.
After removing the stomach, the surgeon connects the esophagus to the small bowel.
Sleeve gastrectomy
Sleeve gastrectomy is a treatment for obesity. The procedure involves removing around 80% of the stomach, leaving behind a thin “sleeve.”
The purpose of sleeve gastrectomy is to aid in weight loss by restricting how much the stomach can hold. After the procedure, the stomach can hold approximately 50 to 100 milliliters (mL) of fluid. This compares with an average capacity of around
Learn more about weight loss surgery.
Esophagogastrectomy
Esophagogastrectomy involves removing the top of the stomach and part of the esophagus. This may be necessary if the cancer develops or spreads near where the stomach and esophagus join.
Learn more about treatments for esophageal cancer.
Once a person receives the date for their gastrectomy, their care team will provide guidance on how to prepare for the procedure. This can include tips such as:
- aiming for at least
30 minutesTrusted Source of physical activity or exercise each day in the month leading up to the procedure - quitting smoking if applicable
- speaking with a registered dietitian to help prepare for dietary changes that are necessary after the surgery
A person will need to inform their medical team about any conditions they have and any medications and supplements they take, as these factors can affect surgery.
The person will not be able to eat or drink anything for some time before the procedure, typically around 4 to 6 hours beforehand. Their medical team will inform them when they should stop eating or drinking.
On the day
Doctors first administer general anesthesia so the person is asleep during the gastrectomy.
The person may also need to wear compression stockings to prevent blood clots.
What happens during a gastrectomy depends on whether surgeons perform open surgery or laparoscopic surgery.
Open surgery
Open surgery is the most common approach for gastrectomy. It involves the surgeon making one large incision on the abdomen. The exact location of the incision depends on the part of the stomach the surgeon is removing.
If the cancer is at the lower part of the stomach, the surgeon will remove up to two-thirds of the stomach before reattaching the small bowel to the remaining part of the stomach.
If they have to remove the whole stomach, the surgeon will attach the small bowel to the esophagus.
Laparoscopic surgery
Laparoscopic surgery, or keyhole surgery, involves the surgeon making several small cuts rather than one larger incision across the abdomen.
To perform the gastrectomy laparoscopically, the surgeon inserts a laparoscope — a thin, flexible device with a camera on the end of it — into an incision. This allows them to see inside the body and remove the stomach without needing a larger incision.
How long a gastrectomy takes depends on the type of procedure. It typically takes between 2 and 6 hours.
The surgeon or medical team can provide more accurate information about how long the procedure may last.
Immediately after a gastrectomy, a person needs to stay in the hospital for around 1 to 2 weeks.
In the first 48 hours, the individual may need to wear a nasogastric tube. This helps remove fluid from the stomach. They may also need to wear a catheter to collect urine until they are strong enough to leave the bed and go to the bathroom on their own.
While in the hospital, the person will likely need to use a feeding tube. They will also learn about when they can begin to add foods and drinks back into their diet. It can take a number of months for the digestive system to adjust after the procedure.
It may be necessary to continue using a feeding tube for around 2 to 4 weeks after leaving the hospital.
After this time, a person can work with their dietitian to begin reintroducing foods and drinks to their diet in phases.
According to the
Phase 1 takes place around 6 to 8 weeks after surgery. It focuses on consuming smaller meals more frequently rather than fewer larger meals and should be high in protein. A person may also consume fruits, vegetables, grains, and fats.
Phase 2 can begin when a person is able to tolerate phase 1 well. It is important to continue focusing on smaller, more frequent meals that are high in protein.
What foods a person can tolerate in phase 2 can be different for each person. It is necessary to work with a medical team to ensure that the individual is receiving enough nutrition without damaging the stomach.
Learn about the gastric sleeve diet.
If a person undergoes gastrectomy for cancer, they may lose around
If a person has a gastrectomy for obesity, the amount of weight they lose can depend on factors such as how many calories they consume and the level of activity they are able to do.
A person can work with their medical team to establish any weight loss goals and to monitor weight loss after the surgery.
As with any surgery, there are risks of gastrectomy.
Possible complications include:
- leaking from the surgical site
- stricture, which is when the esophagus becomes narrow due to leaking stomach acid
- chest infection
- wound infection
- small intestine blockage
- internal bleeding
A person can talk with their surgeon to discuss ways to minimize the risk of complications and how to treat any that occur.
Life expectancy following gastrectomy depends on factors such as:
- the type of gastrectomy
- the condition the surgery was treating
- the age and overall health of the person
A 2024 study found that the average life expectancy of males over 80 years old who underwent total gastrectomy for gastric cancer was about 5 years. For females over 80 years old, it was around 7 years.
A 2022 study looking at the long-term survival of individuals undergoing gastrectomy for gastric cancer found that the median survival for people under 70 years old was 73.1 months. This compares with a median of 53.5 months for people 70 years old or over.
A person can talk with their doctor to find out more accurate information about their outlook based on their individual circumstances.
Gastrectomy is a major surgery that involves removing part or all of the stomach. Total gastrectomy and partial gastrectomy can help treat stomach cancer.
Esophagogastrectomy involves removing the top of the stomach and part of the esophagus. This can help treat cancer or tumors that develop where the esophagus meets the stomach.
Doctors may recommend sleeve gastrectomy to treat obesity. This procedure involves removing most of the stomach from one side, leaving only a thin tube or sleeve.
An individual will require a stay in the hospital for a few weeks after the surgery, during which time they will usually need to use a feeding tube.
Because it can take months for the digestive system to adjust to the changes made during the procedure, a dietitian will work with the individual to help them gradually reintroduce foods and drinks to their diet.
If a person has any questions about the procedure, they can ask their doctor or surgeon beforehand. The medical professional can also advise on what steps they need to take to prepare for the gastrectomy.
