What is gastrectomy?

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Gastrectomy: Overview

Gastrectomy is surgery to remove all or part of the stomach. It is often done to remove tumors or areas with ulcers. In some cases, the doctor may also cut the nerves that signal the stomach to make acid. This is called a vagotomy.

The doctor will close the cut (incision) in your belly with stitches or surgical staples. These will be removed 7 to 10 days after surgery.

After surgery, your stomach will be smaller than before. This means that you will get full more quickly when you eat. You may need to change the way you eat so that you get enough nutrition. Drink fluids between meals instead of with meals. You may need to eat 5 or 6 small meals each day instead of 2 or 3 large meals.

Most people go home 4 to 5 days after surgery. You will probably be able to return to work or your normal routine in 4 to 6 weeks.

How can you care for yourself after gastrectomy?

Activity

  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start out by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
  • Avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
  • Do not take part in any activity where you could be hit in the belly. This could be sports or playing with children.
  • Hold a pillow over your incision when you cough or take deep breaths. This will support your belly and decrease your pain.
  • Do breathing exercises at home as instructed by your doctor. This will help prevent pneumonia.
  • You can shower. Pat the incision dry. Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
  • Ask your doctor when you can drive again.
  • You will probably need to take 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
  • Ask your doctor when it is okay for you to have sex.

Diet

  • Your doctor will give you specific instructions about what to eat after the surgery. For the first 2 to 6 weeks, you will need to follow a liquid or soft diet. Bit by bit, you will be able to add solid foods back into your diet.
  • Have 5 or 6 small meals each day instead of 2 or 3 large meals.
  • Chew each bite of food very well. Eat slowly. You may need to take 20 to 30 minutes to eat a meal.
  • Avoid crusty breads, bagels, tough meats, raw vegetables, nuts and seeds (including crackers and breads that have nuts and seeds), and other foods that are hard to digest.
  • If you feel full quickly, try to drink fluids between meals instead of with meals.
  • Avoid carbonated beverages, such as soda pop.
  • Avoid drinking with straws. This may help you swallow less air when you drink.
  • Check with your doctor before drinking alcohol. Your body may absorb alcohol more quickly after surgery.
  • You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. Take a fiber supplement every day. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

  • Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • Continue to take your acid-reducing medicine as your doctor tells you.

Incision care

  • If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
  • Wash the area daily with warm, soapy water and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.
  • Keep the area clean and dry.

How do you prepare for a gastrectomy?

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

  • Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
  • Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
  • Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

After gastrectomy: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You are short of breath.

Call your doctor now or seek immediate medical care if:

  • You are sick to your stomach or cannot keep fluids down.
  • You have pain that does not get better after you take pain medicine.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the wound.
    • Pus draining from the wound.
    • A fever.
  • You have loose stitches, or your incision comes open.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of the knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You cannot pass stool or gas.
  • Bright red blood has soaked through your bandage.

Watch closely for any changes in your health, and be sure to contact your doctor if you have any problems.

After gastrectomy: Overview

After gastrectomy, you will have some belly pain. You may need pain medicine for the first week or so after surgery. The cut that the doctor made (incision) may be tender and sore.

Because the surgery makes your stomach smaller, you will get full more quickly when you eat. Food also may empty into the small intestine too quickly. This is called dumping syndrome. It can cause diarrhea and make you feel faint, shaky, and nauseated. It also can make it hard for your body to get enough nutrition. If you think you are having problems with dumping syndrome, talk to your doctor.

It is important to avoid heavy lifting or strenuous exercise while you are recovering so that your belly can heal. You will probably be able to return to work or your normal routine in 4 to 6 weeks.

What happens on the day of your gastrectomy?

  • Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
  • Take a bath or shower before you come in for your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
  • Do not shave the surgical site yourself.
  • Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

  • Bring a picture ID.
  • The area for surgery is often marked to make sure there are no errors.
  • You will be kept comfortable and safe by your anesthesia provider. You will be asleep during the surgery.
  • The surgery will take about 1 to 3 hours.
  • After surgery, the bowel usually "rests" for a few days before it starts working again. You may have a thin plastic tube in your nose that goes into your stomach. This tube drains stomach juices and prevents nausea. The drainage usually looks green, brown, or even black with flecks of blood. The tube will be removed in a few days, after your bowels start working again. After the tube is removed, you can start drinking and eating again.

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