全胃切除术

Dr Majid Ahmed Talikoti
Sr. Consultant - Surgical Oncology

What is gastrectomy and types of gastrectomy?

Gastrectomy is a medical procedure where all or the small part of abdomen is surgically removed. You'll find several forms of gastrectomy: full gastrectomy – the entire abdomen is removed. partial gastrectomy – the reduction of main abdomen surgically.

Gastrectomies are performed to treat cancer and perforations of this stomach wall.

In severe duodenal ulcers it may be necessary to remove the lower percentage of the stomach called the pylorus and the upper portion of the smaller intestine called the duodenum. If there is a sufficient portion of the upper duodenum remaining a gastroduodenostomy is completed, where the remaining portion from the stomach is reattached to the duodenum prior to bile duct and the duct from the pancreas. If the stomach cannot be reattached to the duodenum a gastrojejunostomy is completed, where the remaining portion from the duodenum is sealed off, a hole is cut to the next section of the smaller intestine called the jejunum and the stomach is reattached at this kind of hole. As the pylorus can be used to grind food and slowly release the meals into the small intestine, removal from the pylorus can cause food to relocate into the small intestine faster than normal, leading to gastric throwing syndrome.

Polya's procedure

A type of posterior gastroenterostomy the industry change with the Billroth II procedure. Resection connected with 2/3 with the tummy together with shades drawing a line under with the duodenal stump in addition to retrocolic anastomosis with the full circumference with the wide open tummy to be able to jejunum.

                               
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Post-operative side effects

The most obvious effect of the removal of the stomach is the loss in a storage place for food whilst it is being digested. Since only handful of food can be allowed into the small intestine each time, the patient will have to enjoy small amounts of food regularly to be able to prevent gastric dumping syndrome.

Another major effect is loosing the intrinsic-factor-secreting parietal cells inside stomach lining. Intrinsic factor is crucial for the uptake of vitamin B12 inside terminal ileum and without it the patient will suffer from a vitamin B12 deficiency. This can lead to a variety of anemia known as megaloblastic anaemia (can also be brought on by folate deficiency, or autoimmune disease where it truly is specifically known as pernicious anaemia) which in turn severely reduces red-blood cell activity (known as erythropoiesis, as well as other haemotological cell lineages if severe enough however the red cell is the first for being affected). This can be treated by giving the patient direct injections of vitamin B12.

Another side effect is loosing ghrelin production, which has been proved to be compensated after a while.