What is Partial Gastrectomy

Partial gastrectomy is surgery to remove part of the stomach. This procedure may be done through one incision, or through several tiny incisions using a thin tube with a light and camera on the end (laparoscope).

There are three types of partial gastrectomy. You may have a procedure to remove:

• The lower third of the stomach (antrectomy).
• About half of the stomach (partial gastrectomy).
• Most of the stomach (subtotal gastrectomy).

You may need this surgery if you have:

• Stomach cancer.
• A stomach tumor.
• A condition that causes stomach bleeding or a hole in the stomach (stomach ulcer).
• Scar tissue in the stomach that blocks the digestive tract.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Leaking of stomach juices.
• Scar tissue that causes an obstruction.
• A condition that causes abdominal cramps, nausea, diarrhea, heart palpitations, and dizziness after eating (dumping syndrome).
• An area of weakness in the stomach muscle that may allow organs or tissues to bulge through (hernia).
• A blood clot that forms in a leg and travels to the lungs (pulmonary embolism).

What happens before the procedure?

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one or more of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
• A tube may be placed into your bladder to drain urine (catheter).
• A tube will be inserted through your nose and down into your stomach to drain stomach fluids (nasogastric tube).
• If your procedure will be done through one incision:
  • A long incision will be made from the top of your abdomen to your belly button area.
  • The muscles of your abdomen and the lining that contains your abdominal organs will be opened.
  • Your stomach attachment and some blood vessels may be divided and tied off.
  • Part of your stomach will be removed.
  • The remaining part of your stomach will be connected to your small intestine using stitches (sutures) or staples.
• If your procedure is being done through several smaller incisions:
  • Several small incisions will be made in different parts of your abdomen.
  • Carbon dioxide gas will be pumped into your abdomen through one of the incisions. The gas will gently inflate your abdomen, making it easier for your surgeon to see and work inside your abdomen.
  • The laparoscope will be inserted through an incision. The laparoscope camera will send images to a TV monitor in the operating room. Your surgeon will use these images as a guide during the procedure.
  • Surgical instruments will be placed though another incision. These instruments will be used to remove part of your stomach and connect the remaining part of your stomach to your small intestine.
• Your incision or incisions will be closed with sutures or staples.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You will be given pain medicine as needed. You may receive pain medicine through your IV tube until you can take it by mouth.
• The nasogastric tube will be removed after you start to pass gas. After it has been removed, you will be given clear fluids.
• You will receive fluids and nutrition through your IV tube until you can eat and drink on your own.
• After you can drink fluids well, your IV tube will be removed and you will be able to start eating soft foods.
• Your catheter will be removed when you are able to pass urine.
• Do not drive for 24 hours if you received a sedative.

Partial Gastrectomy, Care After

Refer to this sheet in the next few weeks. These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions. Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• Heartburn or diarrhea after eating. This usually goes away with time.
• An irregular period in females. It may take up to a year for your periods to return to normal.

Follow these instructions at home:

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
• Eat small amounts of food throughout the day instead of large meals. If your meals are too big, you can get a condition called dumping syndrome, which causes cramps, nausea, dizziness, and discomfort.
• Eat foods that have a lot of calcium, iron, vitamin C, and vitamin D.
• Keep a food diary. Write down any problems that develop during the day. Keeping a food diary can help you figure out which foods cause problems for you.

Driving

• Do not drive or operate heavy machinery while taking prescription pain medicine.
• Do not drive for 24 hours if you received a medicine to help you relax (sedative).

Activity

• Rest often, but try to move around each day.
• Gradually add light activity to your daily routine.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

Incision care

• Follow instructions from your health care provider about how to take care of your incision or incisions. Make sure you:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. These skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do not remove adhesive strips completely unless your health care provider tells you to do that.
• Check your incision area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.
• Do not use any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important. During these visits, your health care provider may check that you are getting enough vitamins.

Contact a health care provider if:

• Your pain is not controlled by the medicines you have been given.
• You have a fever or chills.
• You feel nauseous.
• You vomit.
• You have more redness, swelling, or pain around your incision.
• You have more fluid or blood coming from your incision.
• Your incision feels warm to the touch.
• You have pus or a bad smell coming from your incision.
• You have abdominal pain, bloating, pressure, or cramping.
• Your stools do not become firmer over time.
• You have frequent diarrhea or heartburn.
• You experience lightheadedness.
• You experience mental confusion.
• You develop new problems.

Get help right away if:

• Your abdominal pain becomes severe or does not go away.
• You have a fever that is not controlled by medicine.
• You keep vomiting.
• You develop an irregular heartbeat.
• You develop chest pain.
• There is swelling or pain in your legs, calves, or feet.