Stomach removal (gastrectomy)
An operation to remove all or part of the stomach, most often to treat stomach cancer, after which the surgeon reconnects the digestive system.
✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review
In short
- A gastrectomy removes all or part of the stomach, most often for cancer, and the surgeon then reconnects the digestive system.
- It is major surgery: many people develop a complication, and it does not by itself guarantee a cure; it is usually combined with chemotherapy and long-term follow-up.
- Expect roughly 10 days to 2 weeks in hospital and a recovery that can take up to a year, with permanent changes such as smaller meals, possible dumping and vitamin B12 injections after a total gastrectomy.
- When cure is the aim this is normally done within the NHS by a specialist team; ask about the planned extent of surgery, lymph node removal and the multidisciplinary team plan.
A plain-English summary. The detail — including risks and recovery — is below.
At a glance
A general guide. Your surgeon will give you advice for your situation.
Removes the cancer-bearing part of the stomach and nearby lymph nodes so they can be examined.
The cancer has spread beyond what surgery can remove, so a non-surgical plan may be safer and more appropriate.
You are helped to sit up, do breathing exercises and start moving. You may have drips, drains and a tube through the nose, with nutrition through a drip...
A named specialist nurse and a clear contact route for problems after discharge.
You are helped to sit up, do breathing exercises and start moving. You may have drips, drains and a tube through...
A dietitian helps you start fluids and build up gradually. Most people are well enough to go home around 10 days...
UK guidance suggests it usually takes 4 to 6 weeks to build up to solid foods and a varied diet, eaten in small...
Many people return to work around 2 to 4 months, depending on the type of work, as energy improves.
What is a gastrectomy?
A gastrectomy is an operation to remove all or part of the stomach. It is most often done to treat stomach (gastric) cancer, and sometimes for other problems such as a non-cancerous tumour or, rarely, a severe ulcer.
If the whole stomach is removed it is called a total gastrectomy; if part is removed it is a subtotal or partial gastrectomy. In cancer surgery the nearby lymph nodes are usually removed too, so they can be examined and to help treat the disease. After removing the stomach, the surgeon reconnects the digestive system, for example joining the oesophagus or the remaining stomach to the small bowel.
This is major surgery with a long recovery and lasting changes to how you eat and digest food. For cancer that has not spread, it can offer the best chance of long-term control, but it does not on its own guarantee a cure and is usually combined with chemotherapy and specialist follow-up.
Whether it is the right operation, and how much stomach is removed, depends on where the cancer is, its stage, your fitness and a multidisciplinary team's assessment.
Types & techniques
There isn't one single operation. The right approach depends on you — which is something to discuss with your surgeon.
Total versus partial gastrectomy
| Point | Total | Partial/subtotal |
|---|---|---|
| Stomach removed | All of it | Part of it |
| Usual reason | Cancer in middle/upper stomach | Cancer lower in the stomach |
| Reconnection | Oesophagus joined to bowel | Remaining stomach joined to bowel |
| Vitamin B12 | Injections needed for life | May still be needed |
| Eating | Smaller meals, more changes | Smaller meals |
Which operation is right depends on where the cancer is and its stage, not on patient preference alone. Your surgeon will explain the plan for you.
Preparing for your surgery
- You will have staging scans (such as CT, sometimes PET-CT) and, for potentially curable gastric cancer, often a staging laparoscopy; a multidisciplinary team (MDT) agrees the plan.
- Many people have chemotherapy before and after surgery; ask how this fits with the timing of your operation.
- You will usually have fitness checks because this is demanding surgery.
- Stop smoking as early as possible and ask about prehabilitation: improving nutrition, activity and breathing before surgery can help recovery.
- Tell the team about all your medicines, especially blood thinners, and about diabetes, alcohol use and other conditions.
- Plan for a long recovery, help at home, and support with eating little and often afterwards.
- Ask whether you will need vitamin B12 injections and other supplements after surgery.
What happens
A gastrectomy is done under general anaesthetic and can take roughly 3 to 8 hours depending on the type and approach. The surgeon makes either larger cuts (open surgery) or several small cuts (keyhole or robot-assisted surgery) in the tummy, and sometimes the chest.
The affected part or all of the stomach is removed, and in cancer surgery the nearby lymph nodes are removed too. The surgeon then reconnects the digestive system, for example joining the oesophagus or the remaining stomach to the small bowel.
Afterwards you are likely to have drips, drains and sometimes a tube through the nose or a feeding tube into the bowel while you heal. Nurses and physiotherapists help you start moving and doing breathing exercises early to reduce the risk of chest complications.
Most people stay in hospital for around 10 days to 2 weeks, though this varies and complications can lengthen the stay.
Is this operation right for me?
A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.
May not be suitable if…
- The cancer has spread beyond what surgery can remove, so a non-surgical plan may be safer and more appropriate.
- You are not fit enough for major surgery and a long recovery, based on overall assessment.
- Your nutrition is very poor and needs improving before surgery could be considered.
- A multidisciplinary team judges that the risks outweigh the likely benefit for your situation.
Delay surgery if…
- You have an active infection or are acutely unwell.
- Your nutrition or fitness can be improved first with prehabilitation.
- Planned chemotherapy before surgery is not yet complete.
- Important staging results, such as a staging laparoscopy, are still awaited.
- Your blood-thinning or other medication needs adjusting before surgery.
Alternatives to discuss
- Endoscopic treatment (such as endoscopic resection) for very early, superficial stomach cancers.
- Chemotherapy, immunotherapy or targeted treatment for cancer that has spread.
- Surgery only to relieve a blockage (without aiming to cure) when the cancer cannot be fully removed.
- An oesophageal or duodenal stent or other palliative measures for symptoms when cure is not possible.
- Best supportive (palliative) care focused on symptoms and quality of life.
Before you decide
Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.
What matters most to me?
Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.
What are all my options?
Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.
What would make me pause?
Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.
What happens if I do nothing today?
For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.
Anaesthetic choices
The safest option depends on the operation, your health, the facility and your surgeon/anaesthetist. Ask what is planned and why.
Benefits
- Removes the cancer-bearing part of the stomach and nearby lymph nodes so they can be examined.
- Offers the best chance of long-term control or cure for some cancers that have not spread.
- Provides accurate (pathological) staging that guides whether further treatment is needed.
- Can relieve symptoms such as a blockage caused by a tumour.
- Is part of a planned, specialist treatment pathway rather than a stand-alone fix.
Risks & complications
- Pain, tiredness and a long recovery, with reduced appetite and weight loss.
- Big changes to eating and digestion, including needing smaller, more frequent meals.
- Dumping syndrome: feeling sweaty, faint, sick or having loose stools soon after eating.
- Temporary tubes and drains and a hospital stay of around 10 days to 2 weeks.
- A leak where the digestive system is rejoined (anastomotic leak), which may need further treatment.
- Chest infection or pneumonia.
- Blood clots in the legs or lungs, bleeding or wound infection.
- Reflux of acid or bile, and difficulty swallowing.
- Vitamin and mineral deficiencies, including the need for vitamin B12 injections, especially after a total gastrectomy.
- Need to return to theatre for a serious complication.
- Damage to nearby organs during surgery.
- Life-threatening complications; this is major surgery and a small number of people do not survive the operation or its early complications.
UK patient information notes that up to around half of people having this operation develop some complication, which can lengthen the hospital stay; most are managed and many are minor, but some are serious. Results tend to be better in high-volume specialist centres, so ask how many of these operations the unit does, what their complication and survival figures are, and how problems would be handled. Your own risk depends on your fitness, nutrition and the stage of the cancer.
Published figures to discuss
Risk and outcome figures vary a great deal with the stage of the cancer, your fitness, the extent of surgery and how many of these operations the centre performs. UK audit data show outcomes have improved over time and tend to be better in higher-volume specialist units. The figures below are cautious indicators from UK patient information, not personal predictions.
| Figure | Reported range | How to interpret it | Source / confidence |
|---|---|---|---|
| Developing some complication | Up to around half in UK patient information; recent total-gastrectomy series report about 40–45% within 90 days | Many are minor and managed, but some are serious. Complications can lengthen the hospital stay. | NHS — Gastrectomy complicationsnhs.ukPublished figure |
| Leak at the join (anastomotic leak) | Usually about 1–6% after gastrectomy, higher in total, proximal or complex cases | Can often be treated with drainage, endoscopic treatment and nutrition support, but may need further surgery. | NHS — Gastrectomy complicationsnhs.ukPublished figure |
| Death around the time of surgery | UK NOGCA overall curative OG surgery: about 1.3% at 30 days and 2.7% at 90 days in 2019–20 | Total gastrectomy series often report 30-day mortality around 2% and 90-day around 3–4%; risk is higher with frailty, malnutrition and complications. | NHS — Gastrectomy complicationsnhs.ukPublished figure |
These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.
Recovery — what to expect, and when
Recovery from a gastrectomy is gradual. Most people stay in hospital for around 10 days to 2 weeks, and UK guidance suggests it usually takes 6 to 8 weeks to get back to usual activities, but up to a year to recover fully.
- Eating much smaller amounts and feeling full quickly.
- Weight loss in the early weeks before things stabilise.
- Dumping symptoms such as feeling faint, sweaty or having loose stools after meals.
- Tiredness that can last weeks to months.
- Reflux of acid or bile, which may improve with advice and medication.
Aftercare
- Follow the dietitian's plan: eat little and often (for example around six small meals a day), chew well and avoid large drinks with meals.
- Take prescribed supplements, including vitamin B12 injections if advised, especially after a total gastrectomy.
- Sit upright after eating and avoid lying down straight away to reduce reflux.
- Build up activity gradually, walk daily and avoid heavy lifting for at least 6 weeks.
- Watch your weight and report ongoing loss, difficulty swallowing or persistent vomiting.
- Manage dumping symptoms with smaller meals and by separating food and drink as advised.
- Keep all follow-up appointments and know who to contact with problems.
- Dietitian contact and an eating plan for after discharge.
- Vitamin B12 and other supplements arranged if needed.
- Someone to help at home for the first few weeks.
- A way to weigh yourself and record changes.
- Pain relief and any acid-reducing medicines collected.
- Specialist nurse or unit contact number for problems.
- Follow-up and results appointments noted.
Scars and how they heal
You will have surgical scars whose number and position depend on the approach: open surgery leaves one or more larger scars on the tummy (and sometimes the chest), while keyhole or robotic surgery leaves several smaller scars. Scars are firm and pink at first and usually fade over months.
⚠ Get urgent help if…
- Fever, increasing tummy pain or feeling very unwell, which can signal infection or a leak.
- Breathlessness or chest pain, which need urgent assessment.
- A hot, swollen, painful calf or sudden breathlessness, which can mean a blood clot.
- Vomiting blood or passing black, tarry stools.
- Persistent vomiting or being unable to keep fluids down.
- Wound redness, swelling or discharge.
- Dizziness or fainting, rapid weight loss or signs of dehydration.
Who to contact: your surgeon or clinic first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.
General guidance — it doesn't replace the specific advice your surgeon gives you.
Results & realistic expectations
A good result means the cancer-bearing part of the stomach and the nearby lymph nodes have been removed, ideally with clear margins (no cancer at the cut edges), and that you recover well enough to eat and regain strength.
The removed tissue is examined to give the pathological stage, which is usually more accurate than scans alone. This guides whether further treatment is advised and informs your outlook. Surgery cannot guarantee that cancer will not return, which is why ongoing follow-up matters.
How durable the result is depends on the type and stage of the cancer, whether the margins were clear, how many lymph nodes were involved and any further treatment. Even after a successful operation, cancer can sometimes return, so people are followed up over years. The changes to eating and digestion are usually permanent, though most people adapt over time, and after a total gastrectomy vitamin B12 injections are needed for life.
Combining with other procedures
A gastrectomy for cancer is usually combined with chemotherapy before and after surgery, staging investigations such as a staging laparoscopy, and dietitian support. Some cancers also involve targeted or other treatments. Decisions are made by a multidisciplinary team rather than a single doctor.
Follow-up & long-term care
After surgery you will be reviewed to check healing and eating, discuss the pathology results and plan any further treatment. Follow-up for cancer typically continues at regular intervals over several years to look for signs of recurrence and to support nutrition, including monitoring for vitamin and mineral deficiencies.
- Lifelong vitamin B12 injections after a total gastrectomy, and possibly after a partial gastrectomy.
- Attention to eating little and often, with dietitian input as needed.
- Monitoring and treatment of other vitamin or mineral deficiencies (such as iron) if they develop.
- Regular cancer follow-up appointments and scans as advised.
- Possible long-term medication for reflux or dumping symptoms.
Revision and secondary surgery reality
- Some people need a further procedure for a complication, such as draining a leak or returning to theatre.
- The join can narrow later and may need stretching at endoscopy.
- Further cancer treatment may be advised after surgery depending on the pathology results.
- Eating, weight and supplement needs often require ongoing dietitian and medical review.
Ask your surgeon for their own revision rate, what counts as a revision, and what is included in the written aftercare policy.
What good aftercare looks like
- A named specialist nurse and a clear contact route for problems after discharge.
- Structured dietitian support to build up eating, manage dumping and protect weight.
- A clear plan for vitamin B12 and other supplements where needed.
- A clear plan for results, further treatment and long-term cancer follow-up.
- Quick access back to the surgical team if a complication is suspected.
What affects the cost
Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:
- The surgeon's and assisting team's fees.
- Anaesthetic and any high-dependency or intensive care.
- Theatre time and the length of the hospital stay, which is usually long.
- Whether open, keyhole or robot-assisted techniques are used, and whether it is a total or partial gastrectomy.
- Investigations and staging, and any chemotherapy in the wider plan.
- Dietitian, specialist nurse and follow-up care, including ongoing vitamin B12 injections.
- The cost of managing any complications, which can extend the stay.
- The surgeon's fee and the fees of the wider surgical team.
- Anaesthetic fees and the cost of any high-dependency or intensive care.
- The hospital/theatre fee and an estimate for the length of stay.
- Whether staging investigations and any chemotherapy are included or separate.
- Dietitian, specialist nurse and follow-up appointments, including arrangements for vitamin B12 injections.
- What happens, and who pays, if a complication needs extra treatment or a longer stay.
- How further treatment is arranged once pathology results are known.
On the NHS? Gastrectomy for cancer is normally provided on the NHS through a specialist oesophago-gastric team when treatment aims to cure; private care may be used for speed of assessment, choice of consultant or a second opinion.
You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Consent traps and marketing red flags
These are not small details. They are often where patients lose choice, time to reflect, or realistic expectations.
Consent traps
- Being given a sense that surgery alone guarantees a cure, without discussion of stage, recurrence risk and further treatment.
- Not discussing the serious, sometimes life-threatening, risks and the chance of a long stay.
- Not explaining the permanent changes to eating, weight, dumping and the need for vitamin B12 after a total gastrectomy.
- No clear plan for nutrition support or what happens if there is a leak or other complication.
- Not discussing alternatives such as endoscopic treatment for very early cancers.
Marketing red flags
- Any claim of a guaranteed cure or being 'cancer-free' from surgery alone.
- Promoting keyhole or robotic surgery as without risks or much safer rather than an alternative approach with similar serious risks.
- Downplaying the recovery, the chance of complications or the lifelong changes to eating.
- Pressure to decide quickly without a multidisciplinary team plan or a second opinion.
Choosing a surgeon safely
- Check your surgeon is on the GMC Specialist Register for this area.
- Make sure they practise at a CQC-registered location, and look for membership of bodies like BAAPS or BAPRAS.
- You're entitled to a two-stage consent process with time to reflect (a cooling-off period). The surgeon who will operate must consent you — not a salesperson.
- Be wary of pressure: time-limited offers, discounts or deposits taken before you've had time to think are red flags, not bargains.
- You're entitled to your total cost in writing — including aftercare and any revision — before you decide.
Questions to ask your medical professional
Take this to your consultation. A good surgeon will welcome every one of these.
- Will I need part or all of my stomach removed, and why?
- How many of these operations do you and this unit do each year, and what are your results?
- What does my staging show, and is the aim to cure or to control the cancer?
- What further treatment, such as chemotherapy, is planned before or after surgery?
- What are my personal risks given my fitness and other conditions?
- How will my eating change, and what supplements will I need afterwards?
- What follow-up will I have, and what happens if the cancer comes back?
- Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
- Will you be the surgeon who carries out my operation, and who looks after me afterwards?
- What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
- What does a realistic result look like — and what can this operation not achieve?
- What are my options, including waiting, doing nothing for now, or choosing a different approach?
- Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
- What is the total cost in writing, including any follow-ups, and how much time do I have to decide?
Frequently asked questions
Is a gastrectomy available on the NHS?
Can I live without a stomach?
How long will I be in hospital?
What is dumping syndrome?
Will I lose a lot of weight?
Why do I need chemotherapy as well as surgery?
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How we made this page
Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →
Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.
Sources & standards: NHS — Gastrectomy NHS — Gastrectomy: how it's done NHS — Recovering from a gastrectomy NHS — Gastrectomy complications NICE NG83 — Oesophago-gastric cancer: assessment and management Cancer Research UK — Types of surgery for stomach cancer National Oesophago-Gastric Cancer Audit (NATCAN) NOGCA 2012–2020 analysis of oesophago-gastric cancer surgery outcomes — BJS Anastomotic leakage after gastrectomy in 3,926 patients — Frontiers in Oncology Morbidity and mortality of total gastrectomy — PubMed
Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.
Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.
Related guides: Stomach cancer surgery · Partial stomach removal (partial gastrectomy) · Oesophagus removal (oesophagectomy) · Oesophageal cancer surgery · Gastric band removal or adjustment