Gastrectomy

A gastrectomy is one of the last resorts for people with gastroparesis. It involves the removal of all of the stomach (total gastrectomy) or part of the stomach (partial gastrectomy). 

During the procedure:

Depending on the individual patient, the surgeon will remove up to 95% of the stomach. Once the stomach has been removed, the intestines are brought up and attached to either the remainder of the stomach or directly to the esophagus. 

In the case of a partial gastrectomy, the intestines are attached to the remainder of the stomach. In a total gastrectomy the surgeon may leave a small pouch of stomach to attach to the intestines, if possible. Over time, the intestines form a pouch and begin to take on the role of the stomach.

After the procedure:

The gastrectomy can be effective in some people and improve quality of life. The results after a gastrectomy may not be felt for months, but side effects are completely different from GP symptoms. In a lot of cases, the patient is able to eat fairly normally after a year or two.  However, most patients cannot eat perfectly normally, but feel that the improvement in eating was worth the operation. There are significant risks with this operation which should be evaluated carefully.

The biggest complication of this procedure includes the potential to develop dumping sydrome, a condition in which the pyloric sphincter is damaged and empties food too quickly into the small bowel. Rather than regulate the rate at which food digests, the stomach will often "dump" a large amount of food into the small bowel all at once. This results in the pancreas excreting too much insulin at once and results in heart palpitations, sweating, shortness of breath, fatigue, dizziness, low blood pressure, diarrhea, syncope, excessive hunger, hypoglycemia, and even shock. A patient may feel like he/she has run a marathon after eating.

There are two forms of dumping syndrome: early and late. Some people have one, while others have both. It can be treated with diet changes. However, when the dumping is severe patients may need certain drugs, such as octreotide/sandostatin, or possibly surgery to correct the problem. Octreotide is a successful treatment option is most cases.