What Is a Gastrectomy?

If you've just heard the word "gastrectomy" in a clinic room, the first question is usually the simplest one: what, exactly, is being removed — and can you eat without it? This walkthrough answers the questions patients ask most, in the order they tend to ask them.

The video at the top of this page, "Combined Complete Total Gastrectomy with Left Hemipancreatectomy," runs just under six minutes. Be aware of what it shows before you press play: it is an advanced surgical case — a complete total gastrectomy combined with removal of part of the pancreas, the spleen and part of the colon lining, with extensive lymph-node clearance, performed for locally advanced gastric cancer. Most gastrectomies are smaller operations than this one, but the video is a clear look at what a total gastrectomy involves at its most extensive. For the wider background, our cancer hub collects related guides and videos.

First question: what does "gastrectomy" actually mean?

A gastrectomy is an operation to remove part or all of the stomach. Removing only the lower part is a partial (or distal) gastrectomy; removing the whole stomach is a total gastrectomy. It is not the same operation as a sleeve gastrectomy — despite the similar name, that is a weight-loss procedure that narrows the stomach but leaves it in place, covered in our guide to gastric sleeve surgery. A gastrectomy in the sense used here removes stomach tissue altogether, and the food pipe is then rejoined to what remains.

Why would a stomach need to be removed?

The most common reason is stomach (gastric) cancer, where removing the stomach — or the part containing the tumour, along with nearby lymph nodes — is part of the treatment plan. Less often, gastrectomy is considered for other serious stomach problems, such as a large non-cancerous tumour, a perforation or severe injury, or bleeding that cannot be controlled any other way. Which operation is offered, and how much is removed, depends on where the problem sits in the stomach and how far it extends — that's a decision your surgical team makes from your scans and test results, not from a general guide like this one.

How is the operation done, and how is eating reconnected?

Gastrectomy is major surgery under a general anaesthetic, done through an open incision or, in suitable cases, with keyhole (laparoscopic) techniques. Once the affected part of the stomach is removed, the surgeon rebuilds a route for food. After a partial gastrectomy, the remaining stomach is joined to the small intestine. After a total gastrectomy, the food pipe (oesophagus) is joined directly to the small intestine — a join called an oesophagojejunostomy.

That join is delicate work, and you can see one detail of it in the short video "Anchoring suture of esophagojejunostomy after total gastrectomy", about a minute and a half long. Alongside the stapled join, the surgeon places silk stitches that anchor the small intestine in position, restoring the support the removed stomach used to provide. When cancer is the reason, nearby lymph nodes are usually removed at the same operation, as the anchor video's extensive node clearance illustrates.

What is eating like afterwards?

Honestly? Different — and that is the part worth preparing for. With part or all of the stomach gone, there's no large reservoir holding a meal, so the pattern that works is small amounts, eaten slowly, more often through the day. Many people find rich or very sugary foods unsettling at first, and it is common to need specific vitamin and mineral supplements long-term, because a smaller (or absent) stomach absorbs some nutrients less well — vitamin B12 is the usual example after total gastrectomy. Your team and dietitian will tailor this to you; the general shape, though, is that eating recovers gradually and most people settle into a workable routine.

It's also worth knowing how this operation differs from another stomach operation you may come across in your reading: fundoplication keeps the whole stomach and simply wraps its top around the food pipe to stop reflux — a much smaller intervention than removing stomach tissue.

References & further reading

• MedlinePlus — Gastrectomy: https://medlineplus.gov/ency/article/002945.htm
• MedlinePlus — Stomach Cancer: https://medlineplus.gov/stomachcancer.html
• NHS — Stomach cancer: treatment: https://www.nhs.uk/conditions/stomach-cancer/treatment/
• National Cancer Institute — Stomach Cancer Treatment: https://www.cancer.gov/types/stomach/patient/stomach-treatment-pdq

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Is a gastrectomy the same as a gastric bypass?

No. A gastric bypass reroutes food around most of the stomach for weight loss but leaves the stomach in place. A gastrectomy physically removes part or all of the stomach, usually to treat cancer or another serious stomach condition.

Can you live without a stomach?

Yes. After a total gastrectomy the food pipe is joined directly to the small intestine, so food still follows a continuous route. Eating changes — smaller, more frequent meals and long-term supplements are typical — but the body adapts.

How long is the hospital stay after a gastrectomy?

It varies with the size of the operation and how recovery goes, but this is major surgery and the stay is usually measured in days rather than hours, followed by a gradual build-up from fluids to soft food. Your team will give you a plan matched to your operation.

Will I lose weight after a gastrectomy?

Some weight loss is common, especially early on, because meals are smaller and appetite takes time to return. Dietetic support, small frequent meals and the supplements your team prescribes are all aimed at keeping that loss manageable.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. If you are facing stomach surgery or have symptoms that worry you, please seek care from your own doctor or surgical team.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/07/26