A gastrectomy is a partial or full surgical removal of the
Gastrectomies are performed to treat cancer and perforations of the stomach wall.
In severe duodenal ulcers it may be necessary to remove the lower portion of the stomach called the
pylorusand the upper portion of the small intestinecalled the duodenum. If there is a sufficient portion of the upper duodenum remaining a Billroth I procedureis performed, where the remaining portion of the stomach is reattached to the duodenum before the bile ductand the duct of the pancreas. If the stomach cannot be reattached to the duodenum a Billroth IIis performed, where the remaining portion of the duodenum is sealed off, a hole is cut into the next section of the small intestine called the jejunumand the stomach is reattached at this hole. As the pylorus is used to grind food and slowly release the food into the small intestine, removal of the pylorus can cause food to move into the small intestine faster than normal, leading to gastric dumping syndrome.
A type of posterior gastroenterostomy which is a modification of the
Billroth IIoperation. Resection of 2/3 of the stomach with blind closure of the duodenal stump and retrocolic anastomosisof the full circumference of the open stomach to jejunum
The first successful gastrectomy was performed by
Theodor Billrothin 1881for cancer of the stomach.
Historically, gastrectomies were used to treat
peptic ulcers. [E. Pólya:Zur Stumpfversorgung nach Magenresektion. Zentralblatt für Chirurgie, Leipzig, 1911, 38: 892-894.] These are now usually treated with antibiotics, as it was recognized that they are usually due to Helicobacter pylori.
In the past a gastrectomy for peptic ulcer disease was often accompanied by a
vagotomy, to reduce acid production. Nowadays, this problem is managed with proton pump inhibitors.
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