GASTRECTOMY

surgical removal of all or part of the stomach, a procedure that is used to treat peptic ulcers. The operation eliminates the gastric-acid-secreting parietal cells in the stomach lining and halts the production of the acid-stimulating hormone gastrin, thus removing the cause of the ulcer. Once a common method of treatment for patients with painful ulcers, gastrectomy is now used only as a last resort if the appropriate drugs have failed or if an ulcer is perforated or hemorrhaging. The most common procedure is antrectomy, which removes the lower half of the stomach (antrum), the chief site of gastrin secretion. The remaining stomach is then reconnected to the first section of the small intestine (duodenum). In a more extensive procedure, subtotal gastrectomy, as much as three-quarters of the stomach is removed, including all of the antrum. The remaining stomach may then be reattached directly to the duodenum or to the jejunum, a more distal part of the intestine beyond the usual site of ulceration. The incidence of ulcer recurrence after gastrectomy is very low (about 2 percent) when the antrum is completely removed. The most significant drawback to gastrectomy is general malnutrition, caused by decreased appetite and by the stomach's decreased ability to digest food.