Antrectomy

Depiction of a patient suffering from peptic ulcers

Diagram showing the anatomy after a partial gastrectomy (Bilroth 02) CRUK 281

Theodor Billroth

Depiction of a stomach cancer patient

Stomach endoscopy 2

Antrectomy is a surgical procedure involving the removal of the antrum, the lower portion of the stomach that produces gastric acid and digestive enzymes. This procedure is typically performed to treat conditions such as ulcers, gastric cancer, and Zollinger-Ellison syndrome, a disorder that leads to the formation of ulcers due to increased gastric acid secretion.

Indications

Antrectomy is indicated for patients with:

• Peptic ulcer disease (PUD) that is resistant to medical treatment
• Complications of PUD such as perforation or bleeding
• Gastric cancer located in the antrum
• Zollinger-Ellison syndrome as part of a larger surgical intervention to control acid secretion

Procedure

The procedure can be performed using either an open or a laparoscopic approach, depending on the specific circumstances and the surgeon's expertise. During an antrectomy, the surgeon removes the antrum and then reconnects the remaining stomach to the duodenum (the first part of the small intestine) or the jejunum (the second part of the small intestine) in a procedure known as gastrojejunostomy. This resection can significantly reduce the stomach's acid output and alleviate symptoms associated with excessive acid production.

Complications

As with any surgical procedure, antrectomy carries potential risks and complications, including:

• Infection
• Bleeding
• Anastomotic leak (leakage from the site where the stomach is reconnected to the intestine)
• Dumping syndrome, a condition where food moves too quickly from the stomach to the small intestine
• Nutritional deficiencies due to altered digestion and absorption

Postoperative Care

Postoperative care involves monitoring for complications, managing pain, and gradually reintroducing oral intake. Patients may need to adjust their diet and, in some cases, take vitamin and mineral supplements to compensate for reduced absorption.

Outcomes

The outcomes of antrectomy depend on the underlying condition being treated. For patients with peptic ulcer disease, antrectomy can provide relief from symptoms and prevent recurrence. In cases of gastric cancer, the procedure's success depends on the cancer's stage and extent. Long-term follow-up is necessary to monitor for potential complications and ensure adequate nutritional intake.

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