
Diagram of the stomach, showing the different regions.
A 'gastrectomy' is a partial or full surgical removal of the
stomach. The first successful gastrectomy was performed by
Theodor Billroth in
1881 for cancer of the stomach. Gastrectomies are performed to treat cancer, severe cases of
peptic ulcer disease, and perforations of the stomach wall. This procedure is becoming less common as peptic ulcers are now often treated with antibiotics for
Helicobacter pylori or by
endoscopy.
[1] [2]
In severe duodenal ulcers it may be necessary to remove the lower portion of the stomach called the
pylorus and the upper portion of the
small intestine called the
duodenum. If there is a sufficient portion of the upper duodenum remaining a Billroth I procedure is performed, where the remaining portion of the stomach is reattached to the duodenum before the
bile duct and the duct of the
pancreas. If the stomach cannot be reattached to the duodenum a Billroth II is 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
jejunum and 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.
In the past a gastrectomy for peptic ulcer disease was often accompanied by a
vagotomy, where the
vagus nerve is cut to reduce acid production in the stomach. Nowadays, this problem is managed with
proton pump inhibitors.
Polya's operation
A type of posterior gastroenterostomy which is a modification of the Billroth II operation. Resection of 2/3 of the stomach with blind closure of the duodenal stump and retrocolic anastomosis of the full circumference of the open stomach to jejunum
See also Finsterer-Hofmeister operation under Hans Finsterer, German surgeon, 1877–1955.
References
1. E. Pólya:Zur Stumpfversorgung nach Magenresektion.Zentralblatt für Chirurgie, Leipzig, 1911, 38: 892-894.
2. ''KMLE Medical Dictionary Definition of gastrectomy'' The American Heritage Stedman's Medical Dictionary