A gastroenterostomy connects the base of the stomach to the middle of the small intestine, known as the jejunum, bypassing the duodenum in the upper portion of the small intestine. There are a number of medical indications for this surgery, which was historically used in the treatment of several gastrointestinal disorders, including severe ulcers. It is also used in some forms of bariatric surgery to promote weight loss in patients who cannot control their weight through more conservative means. This procedure can be performed in a number of ways, depending on the preferences of the surgeon and why it is being performed.
In a simple gastroenterostomy, the stomach is left intact when the connection to the duodenum is severed and the surgeon makes an anastamosis, a new connection, with the jejunum. The stomach will empty directly into the middle of the small intestine, bypassing the duodenum altogether. Other procedures involve removing part of the stomach as well, either because it is necessary for weight loss or as a result of damage to the stomach tissue. Surgeons make the remainder of the stomach into a small pouch which can be attached to the jejunum.
One reason to need a gastroenterostomy is severe damage to the duodenum. Patients may have trouble with gastric emptying, digestion, and recurrent stomach pain as a result of disease in this area of the bowel. A bypass can be used to skip this area of damaged tissue and restore function to the patient’s digestive tract. Before better methods of controlling ulcers, gastroenterostomy was sometimes considered as a treatment to move past damaged bowel.
In bariatric surgery, skipping the duodenum changes the way the patient metabolizes food and can promote weight loss, especially when it is combined with a partial gastrectomy to shrink the stomach. The patient will eat less food and process it differently, losing weight as a result of these changes. This may be irreversible, depending on the type of surgery performed, and patients need to exercise care during recovery. Patients receive specific recommendations on what to eat and what kinds of supplements to take to promote overall health.
Recovery time from a gastroenterostomy can vary, depending on the specifics of the procedure. Patients may need to start by drinking clear fluids, slowly transitioning to small amounts of soft solids before resuming a more normal diet. They can experience cramping and increased food sensitivity after the procedure, which may result in permanent dietary changes. It can help to discuss recovery and what to expect with a surgeon before the procedure so patients are prepared for what will happen after surgery.