Comprehensive Guide on Antrectomy Surgery

Antrectomy surgery is a widely recommended procedure. This surgical intervention targets the antrum, the lower portion of the stomach that produces the hormone gastrin, which stimulates acid production. By removing the antrum, this surgery helps in reducing acid secretion and alleviating symptoms caused by various gastrointestinal conditions.

Antrectomy surgery is a specialized operation in which the lower part of the stomach, known as the antrum, is removed. This part of the stomach plays a crucial role in stimulating acid production through the hormone gastrin. By surgically removing this section, the procedure aims to reduce excessive acid secretion, relieve persistent symptoms, and prevent further complications such as bleeding, perforation, or cancer spread.

What is Antrectomy Surgery?

Antrectomy is a type of gastric surgery that involves the removal of the antrum, the lower third of the stomach. This area is responsible for secreting gastrin, a hormone that stimulates acid production. The surgery is often performed to treat recurrent peptic ulcers, gastric outlet obstruction, or early stage stomach cancer.

After the antrum is removed, the remaining part of the stomach is connected either to the duodenum (Billroth I procedure) or to the jejunum (Billroth II procedure), depending on the patient’s condition and the surgeon’s recommendation.

Why is Antrectomy Performed?

There are several medical conditions that may necessitate an antrectomy. The most common include :-

1. Chronic peptic ulcers that do not respond to medication.

2. Gastric outlet obstruction, a blockage at the end of the stomach that affects digestion.

3. Stomach cancer, particularly localized tumors in the antral region.

4. Severe gastritis or bleeding ulcers.

By removing the source of excessive acid production and improving gastric emptying, antrectomy helps in providing long term relief from these conditions.

Types of Antrectomy Procedures

While the basic principle of antrectomy remains the same removal of the antral portion of the stomach there are two primary surgical variations :-

1. Billroth I (Gastroduodenostomy) :- In this procedure, the remaining part of the stomach is directly connected to the duodenum. This method maintains a more physiological route for food to pass through the digestive tract.
2. Billroth II (Gastrojejunostomy) :- Here, the stomach is connected to the jejunum, bypassing the duodenum entirely. This approach is often used when the duodenum is inflamed, scarred, or cancerous.

The choice between these methods depends on the underlying medical condition and the overall health of the patient.

Preparing for Antrectomy Surgery

Before undergoing antrectomy, patients are advised to undergo a series of diagnostic tests, such as endoscopy, barium swallow, CT scans, or biopsy, to assess the condition of the stomach and surrounding organs.

Patients are also expected to :-

1. Discontinue certain medications, especially blood thinners, a few days prior to surgery.

2. Refrain from eating or drinking at least 8 hours before the operation.

3. Discuss any chronic conditions like diabetes, hypertension, or heart disease with their healthcare provider.

Pre operative instructions must be followed carefully to ensure a safe surgical experience.

The Antrectomy Procedure: Step by Step

Antrectomy is generally performed under general anesthesia and may take 2 to 3 hours, depending on the complexity. Here’s what typically happens :-

1. An incision is made in the abdominal area (either open or laparoscopic).

2. The surgeon identifies and removes the antral portion of the stomach.

3. The remaining part of the stomach is reattached to either the duodenum or jejunum.

4. Bleeding is controlled, and the incision is closed.

Laparoscopic antrectomy is increasingly preferred due to its minimal invasiveness, smaller scars, and faster recovery time.

Recovery After Antrectomy

Recovery from antrectomy varies depending on the individual, type of procedure, and overall health. Most patients are required to stay in the hospital for 5 to 7 days post surgery.

During recovery :-

1. Liquid diets are introduced gradually, followed by soft foods.

2. Patients may experience nausea, bloating, or dumping syndrome, where food moves too quickly from the stomach to the intestines.

3. Pain management and nutritional support are provided.

Full recovery can take 4 to 6 weeks, during which patients must avoid strenuous activities and follow dietary guidelines strictly.

Risks and Complications

As with any surgical procedure, antrectomy carries potential risks. Some of the most common complications include :-

1. Infection or bleeding at the surgical site

2. Dumping syndrome leading to nausea, diarrhea, and dizziness

3. Delayed gastric emptying

4. Nutritional deficiencies, especially in iron, vitamin B12, and calcium

5. Anastomotic leak, where the new connection between the stomach and intestine leaks

However, with proper surgical technique and post-operative care, these complications can be minimized significantly.

Diet and Lifestyle After Antrectomy

Long-term success after antrectomy depends greatly on adopting a healthy lifestyle. Dietary modifications are crucial and include :-

1. Eating smaller, frequent meals instead of large ones

2. Avoiding sugar rich foods that can cause dumping syndrome

3. Consuming foods rich in iron, protein, and vitamins

4. Staying hydrated throughout the day

Patients may also need to take vitamin supplements and undergo regular blood tests to monitor nutrient levels.

Avoiding smoking and alcohol is strongly recommended to enhance healing and reduce the risk of future gastrointestinal problems.

When to Call Your Doctor?

After discharge, it is important to monitor your body’s response to surgery. Contact your healthcare provider if you experience :-

1. Severe abdominal pain or swelling

2. Persistent vomiting

3. High fever or chills

4. Signs of infection around the incision site

Early intervention can prevent serious complications and support faster recovery.

Conclusion

Antrectomy surgery is a highly effective treatment for chronic stomach issues such as peptic ulcers and early gastric cancer. With advancements in surgical techniques and post operative care, most patients experience significant relief and improved quality of life.