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Gastrectomy
Video
Introduction
The indications and approaches for gastrectomy have evolved in recent years. Before the introduction of effective diagnostic modalities and medical therapies for peptic ulcer disease (PUD) and Helicobacter pylori infection, most gastric operations were performed for complications of those diseases. Now, malignancy is the most common indication for gastric resection, with more than 26,000 new cases of gastric cancer occurring in the United States per year. Although it is one of the least commonly diagnosed cancers in the United States, it remains the third most common cause of cancer-related mortality worldwide. Underlying histologies include adenocarcinoma, lymphoma, carcinoid, gastrointestinal stromal tumor (GIST), and leiomyosarcoma. Indications for resection in the context of PUD include failure of healing despite appropriate medical management, hemorrhage, perforation, and obstruction. Other benign indications for resection include intractable hemorrhagic gastritis and end-stage gastroparesis refractory to medical management, pyloromyotomy, or gastric neurostimulator placement.
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