What Disease Requires Gastrectomy?

The stomach is a very important organ in the human body, and in case of severe diseases, its removal may be considered. Stomach removal can be partial or total, and the extent of the removal depends on the condition of the stomach disease. Typically, stomach removal is necessary for diseases such as gastric cancer, duodenal ulcer, and gastric tumor.

In stomach removal surgery, total gastrectomy, subtotal gastrectomy, hemi-gastrectomy, and antrectomy are commonly used. (1) Total gastrectomy is used for gastric cancer located in a large area of the stomach. (2) Subtotal gastrectomy is suitable for duodenal ulcer, gastric ulcer with high gastric acid secretion, and distal gastric tumor. (3) Hemi-gastrectomy is suitable for gastric ulcer with low gastric acid secretion. (4) Antrectomy is mainly used as an additional surgery for vagotomy or selective vagotomy in duodenal ulcer.

Weight loss after partial or total gastrectomy is a common concern for many patients. Currently, insufficient intake of nutrients is considered the main cause of weight loss. 1. The most common clinical situation is that due to fear of obstruction and other complications, some patients only consume liquid foods such as porridge and noodles for a long time after discharge, leading to nutritional deficiency. Additionally, patients may find it inconvenient to eat more than five meals a day, and the amount of food consumed at each meal is small, resulting in insufficient total food intake and weight loss. Both of these situations require special attention by patients and their families. 2. Some patients restrict their food intake due to discomfort after eating, leading to weight loss. In such cases, it is necessary to consult with the treating physician based on the condition, and sometimes medication may be prescribed to manage symptoms or provide additional nutritional support. 3. Although stomach removal has minimal impact on the absorption of most nutrients, there may be some obstacles in the absorption of specific nutrients such as vitamin B12. Additionally, the absorption of iron, calcium, and phosphorus may also be affected. Therefore, it is important to monitor and address these issues postoperatively.