- Stanley W Ashley, MD
Stanley W Ashley, MD
- Section Editor — Pancreatic and Hepatobiliary Surgery
- Chief Medical Officer and Senior Vice President for Clinical Affairs
- Brigham and Women’s Hospital
- Frank Sawyer Professor of Surgery
- Harvard Medical School
Various forms of gastric resection and reconstruction are used to manage a variety of benign and malignant conditions of the stomach. Similar to any other abdominal surgery, gastric surgery can result in postoperative complications. Although complications are considerably less common today, historical data would suggest that approximately one in four patients reports significant symptoms after gastric surgery; in 2 to 5 percent, these symptoms are disabling .
The complications specific to gastric surgery will be reviewed in this topic. Complications common to all abdominal surgeries, such as bleeding, infection, bowel obstruction, fascia dehiscence, or hernia, are discussed in another topic (see "Complications of abdominal surgical incisions"). Complications of bariatric surgical procedures (eg, Roux-en-Y gastric bypass or sleeve gastrectomy) are discussed elsewhere. (See "Late complications of bariatric surgical operations" and "Bariatric operations: Perioperative morbidity and mortality".)
The derangements in gastrointestinal function that occur following gastric resection depend upon the portion and volume of gastric tissue removed, and the type of reconstruction.
Gastric resection — Gastric resections include (see "Partial gastrectomy and gastrointestinal reconstruction" and "Total gastrectomy and gastrointestinal reconstruction"):
●Partial gastrectomy (proximal or distal)
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- POSTGASTRECTOMY ANATOMY
- Gastric resection
- DIAGNOSING POSTGASTRECTOMY COMPLICATIONS
- COMPLICATIONS RELATED TO ANASTOMOSIS
- - Duodenal stump leak
- - Afferent and efferent loop syndrome
- - Jejunal intussusception
- - Internal hernia
- Marginal ulcer
- COMPLICATIONS RELATED TO MOTILITY
- Rapid transit
- - Dumping syndrome
- - Postvagotomy diarrhea
- Slow transit
- - Gastric stasis
- - Alkaline gastritis
- - Roux stasis syndrome
- LONG-TERM COMPLICATIONS INVOLVING REMNANT STOMACH
- Peptic ulcer
- Remnant cancer
- NUTRITIONAL DEFICIENCIES
- SUMMARY AND RECOMMENDATIONS