Gastrectomy (partial or total removal of the stomach)

Gastrectomy is the removal of part of the stomach (partial or subtotal gastrectomy) or all of it (total gastrectomy). It is most often performed for stomach cancer, sometimes for a benign tumour or a gastrointestinal stromal tumour (GIST), and more rarely for a complicated ulcer. It is different from sleeve gastrectomy, which is a weight-loss operation. The operation is performed through open surgery or laparoscopy depending on the situation. For cancer, the surgeon removes the diseased part of the stomach with a safety margin, together with the nearby lymph nodes (lymphadenectomy). The digestive tract is then reconstructed: the remaining stomach, or the oesophagus after total gastrectomy, is joined to a loop of small intestine. For cancer, the decision is taken at a multidisciplinary team meeting bringing together surgeons, oncologists, gastroenterologists and radiologists. Chemotherapy before and/or after surgery is often recommended. Nutritional status is assessed and improved before surgery if needed. At Clinique Pasteur Tunis, gastrectomy is supported by a full assessment (gastroscopy with biopsies, CT scan), nutritional preparation, available intensive care and dietary follow-up after discharge, which is essential for learning to eat again.