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Stomach Resection/Total Gastrectomy


A stomach resection/total gastrectomy is mostly performed for cure. There is no agreement on how extensive the lymph node dissection should be. In Japan and some treatment centers in the West, an extensive dissection is performed (D2 resection). This has not been common in Norway. It has been shown that a splenectomy or particulary distal resection of the pancreas should not be routinely performed as either may increase morbidity and mortality. Studies have shown that an extensive lymph node dissection can be performed with low mortality and morbidity when it is centralized to departments with a high volume of treatments and special competence.

Surgery has two phases:

  • Resection of stomach tumor with lymph nodes en bloc
    • Either stomach resection of distal tumor in the stomach
    • Or total gastrectomy for proximal tumor (cardia/body) or diffuse growing tumor
  • Reconstruction of digestive tract


  • Distant metastasis and peritoneal carcinosis
  • Local invasion of pancreas, aorta, transverse colon, and hepatoduodenal ligament 
  • Other complicating illness 


  • Curative

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