Treatment of Partial Gastrectomy

Partial gastrectomy is a surgical procedure that involves the removal of a portion of the stomach. It is most commonly performed to treat stomach cancer, benign tumors, bleeding ulcers, or other gastrointestinal conditions that do not respond to conservative treatments. Understanding the treatment process, recovery timeline, and post-operative care can help patients better prepare for the journey ahead.

With advancements in surgical techniques, including minimally invasive laparoscopic options, the outcomes of partial gastrectomy have greatly improved in recent years. Patients undergoing this procedure can now expect faster recovery times, fewer complications, and a better quality of life post surgery. However, understanding the full treatment journey from diagnosis and surgical planning to post operative recovery and long term care is essential for patients and caregivers alike.

What Is Partial Gastrectomy?

Partial gastrectomy refers to the surgical removal of a section of the stomach, usually the lower part (known as the antrum), although other sections may also be removed depending on the diagnosis. After the removal, the remaining part of the stomach is reconnected to the small intestine, typically using a procedure called gastroduodenostomy or gastrojejunostomy. This surgery aims to relieve symptoms, eliminate diseased tissue, and restore normal digestion as much as possible.

Why Is Partial Gastrectomy Performed?

This surgical intervention is usually recommended in cases where part of the stomach is severely affected by disease or damage. Some of the most common conditions that may require a partial gastrectomy include :-

1. Stomach cancer localized to one portion of the stomach.

2. Peptic or gastric ulcers that have not healed with medication and are causing bleeding or obstruction.

3. Gastrointestinal stromal tumors (GISTs) or other benign growths.

4. Severe obesity, in selected cases, though newer procedures are generally preferred for bariatric surgery.

Doctors usually decide on partial gastrectomy when less invasive treatments fail or when there is a high risk of complications from the diseased portion of the stomach.

Preparing for Surgery

Before undergoing a partial gastrectomy, patients will go through a series of pre-operative evaluations. These may include blood tests, imaging studies like CT scans or endoscopies, and nutritional assessments. Patients are usually advised to stop eating or drinking a certain number of hours before surgery.

It is also important to review any current medications with the surgical team, especially blood thinners or medications that affect blood clotting. In some cases, a temporary change in medications or supplements may be necessary.

Treatment of Partial Gastrectomy

Partial gastrectomy can be performed using traditional open surgery or minimally invasive laparoscopic techniques. The choice of technique depends on factors like the patient’s overall health, the location and size of the affected stomach portion, and the surgeon’s expertise.

In an open partial gastrectomy, a large incision is made in the abdomen to access the stomach. The diseased portion is removed, and the remaining stomach is surgically connected to the small intestine.

In a laparoscopic partial gastrectomy, several small incisions are made. Special instruments and a camera are inserted to guide the removal and reconnection procedure. This method usually results in faster recovery, less post-operative pain, and shorter hospital stays.

The surgery typically lasts 2 to 4 hours, and patients are monitored in the recovery room immediately afterward.

Recovery After Partial Gastrectomy

Recovery varies depending on the individual and whether the surgery was open or laparoscopic. Most patients stay in the hospital for 4 to 7 days after an open surgery, or 2 to 4 days after a laparoscopic procedure.

Initially, patients are not allowed to eat or drink until the digestive system starts to function again. Nutrition is often delivered intravenously or via feeding tube for the first few days. Gradually, a liquid diet is introduced, followed by soft foods, and eventually, solid food as tolerated.

Common post operative symptoms include :-

1. Abdominal pain or discomfort

2. Nausea or vomiting

3. Bloating or fullness after small meals

4. Temporary fatigue or weakness

Medications are prescribed to manage pain and reduce stomach acid. Most patients can return to light activities within 2 to 3 weeks, but complete recovery may take 6 to 8 weeks.

Nutritional and Lifestyle Adjustments

One of the most critical aspects of recovery after partial gastrectomy is managing dietary changes. Since the stomach’s capacity is reduced, patients must adapt to smaller, more frequent meals throughout the day. A dietitian often works closely with the patient to help them meet their nutritional needs while avoiding complications like dumping syndrome, a condition where food moves too quickly into the small intestine causing nausea, dizziness, and diarrhea.

Tips for long-term success include :-

1. Eating 5 to 6 small meals daily

2. Chewing food thoroughly

3. Avoiding sugary, spicy, or greasy foods

4. Drinking fluids between meals, not during

5. Taking vitamin and mineral supplements as prescribed (e.g., B12, iron, calcium)

Some patients may also need long term follow ups to monitor for nutrient deficiencies and ensure that no recurrence of the underlying disease has occurred.

Risks and Complications

As with any major surgery, partial gastrectomy carries certain risks. While most procedures are successful, potential complications may include :-

1. Infection at the incision site

2. Bleeding or blood clots

3. Leakage at the surgical connection (anastomosis)

4. Bowel obstruction

5. Delayed gastric emptying

6. Nutritional deficiencies

Early detection and prompt management of complications can significantly improve outcomes. Regular follow-ups with your surgical team are essential during the first few months post surgery.

Long Term Outlook

The prognosis after a partial gastrectomy depends on the underlying reason for the surgery. In cases of early-stage stomach cancer or benign conditions, many patients go on to live healthy, active lives with minimal long-term limitations. When surgery is part of cancer treatment, additional therapies such as chemotherapy or radiation may be required, and the recovery timeline may be extended.

Lifestyle modifications, such as eating a healthy diet, avoiding alcohol and tobacco, and maintaining a healthy weight, can support long term digestive health after surgery.

Conclusion

Partial gastrectomy is a life saving surgical procedure used to treat a range of serious stomach conditions. Thanks to advancements in surgical techniques and post-operative care, patients can expect better outcomes and improved quality of life.