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What are the complications of gastrectomy?

Gastrectomy—or the removal of part of the stomach—is a procedure performed by Best General Surgeon in Karachi for a number of health conditions. However, it is most commonly performed for the treatment of gastric cancer. Read on to know more about gastrectomy, its indications, techniques, and complications:

What is gastrectomy?

Gastrectomy refers to the removal of part of the stomach as part of the treatment for a number of conditions, including: bleeding gastric ulcers, stomach cancer, benign polyps, and perforation of the stomach wall. Less commonly, it is performed for life-threatening obesity, non-cancerous tumors, and esophageal cancer. 

Depending on the region of the stomach removed, gastrectomy can be complete, partial, or sleeve. With removal of part of the stomach, there is modification in the dietary changes, however, the body is still able to absorb nutrition from food. Following the surgery, several lifestyle changes need to be made, as there can be complications. 

If the procedure is performed through a long incision in the abdomen, the procedure is called open gastrectomy. Alternatively, the surgery can be performed through operating scope and small incisions, called minimally-invasive gastrectomy. 

What are the indications of gastrectomy?

Gastrectomy is used to treat:

  • Gastric bleeding 
  • Stomach cancer 
  • Benign and non-cancerous tumors 
  • Inflammatory disorders of the stomach 
  • Growths or polyps in the stomach 
  • Peptic or duodenal ulcers 

Who should not have gastrectomy?

Gastrectomy should not be performed in:

  • Individuals who have low proteins in the blood—hypoproteinemia 
  • Individuals with low red blood cell count—anemia. 

Presence of such conditions predispose the patient to complications following surgery. 

What are the types of gastrectomy?

The three main types of gastrectomy are:

  • Partial gastrectomy: as the name implies, this technique involves removal of part of the stomach, and in case of stomach cancer, removal of the involved lymph nodes as well. After the removal of part of the stomach, the remaining part is joined with the small bowel. Depending on the site of the tumor, lower or upper part of the stomach may be removed. If the upper part of the stomach is removed—it is called proximal gastrectomy, and if the lower part of the stomach is resected—it is called distal gastrectomy. Of the two procedures, distal gastrectomy is performed much more commonly. 
  • Sleeve gastrectomy: in this type of procedure, three-quarters of the stomach is removed, to form a smaller and longer stomach. 
  • Esophago-gastrectomy: in this procedure, the top part of the stomach, along with the esophagus is removed. 
  • Complete gastrectomy: if there is complete removal of the stomach, the procedure is called complete gastrectomy. Once the stomach is removed the esophagus is connected to the small bowel. 

What are the complications of gastrectomy?

The complications of gastrectomy include:

  • Diarrhea
  • Acid reflux
  • Pernicious anemia 
  • Osteoporosis 
  • Vitamin deficiency 
  • Weight loss 
  • Bleeding 
  • Gastric dumping syndrome 
  • Wound infection 
  • Incision infection 
  • Internal bleeding 
  • Vomiting 
  • Stricture formation 
  • Pneumonia 
  • Breathing difficulty 

How to treat post-gastrectomy syndrome?

The treatment of post-gastrectomy syndrome begins with dietary changes. These changes include eating less carbohydrate and more protein. Foods to avoid include: candy, cookies, pastries, sweetened breads, and sodas. Foods that help with post-gastrectomy syndrome include: high fiber diet and even supplements like psyllium, methylcellulose, complex carbohydrates, vegetables and decaffeinated, non-carbonated drinks throughout the day. 

Moreover, adverse effects can be avoided if the food is eaten in fix to six small meals instead of three big meals. With meals, less fluid should be consumed, to control the symptoms of post-gastrectomy syndrome. In fact, fluid should be consumed at least 45 minutes after meals. To prevent dehydration, beverages and water should be consumed during the rest of the day.

Another complication of gastrectomy is vitamin deficiency—particularly pernicious anemia due to vitamin B12, and calcium deficiency. Thus, Shifa International Hospital experts recommend good oral supplements, especially those containing iron and calcium. 

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