Gastroenterostomy is a general term that describes two types of surgical procedures in which the stomach is surgically reconnected to the small intestine after removal of all or part of the stomach or part of the small intestine. Once the gastrectomy is performed, the surgeon must join (anastomosis) the remaining part of the stomach to the small intestine to allow for movement of digested food and fluids. If the remaining part of the stomach is joined to the first part of the small intestine (duodenum), the procedure is called a gastroduodenostomy. When joined to the middle section of the small intestine (jejunum), the procedure is called a gastrojejunostomy.



A gastroenterostomy may be indicated for those with benign or cancerous tumors of the stomach, peptic ulcer disease that is unresponsive to medical therapy, and slowed gastric motility (gastroparesis).
Peptic ulcer disease (PUD) is a collective term to describe ulcers that arise in the stomach or first part of the small intestine (duodenum) as a result of an overproduction of acid and pepsin (an enzyme). Frequently, Helicobacter pylori bacteria are found in the stomachs of individuals with PUD.

The exact cause of gastroparesis is not known. However, a disruption of the nerve stimulation in the intestine seems to be a factor. It is a common complication of diabetes or visceral nerve disease such as seen with systemic sclerosis. It may also be a complication following surgical cutting of the vagus nerve (vagotomy).


Reason for Procedure

A gastroenterostomy may be done as a surgical intervention for peptic ulcer disease, to remove tumors of the stomach, or to facilitate emptying of the stomach in conditions of slowed gastric motility. A gastroenterostomy usually accompanies a surgical resection of the stomach (gastrectomy). Once the gastrectomy is performed, the surgeon must create a new opening from the stomach to the intestines (enterostomy). This type of procedure is now being performed as one of the surgical procedures in individuals who are severely obese. This type of surgery, called bariatric surgery, encompasses gastroenterostomy, gastroplasty, and jejunal bypass.



General anesthesia is administered. One tube may be inserted to drain the bladder (urinary catheter) and another to drain the stomach (nasogastric tube) contents. The surgeon creates an incision that runs midline from the ribcage to the lower abdomen. The surgeon uses either surgical stitches or a stapling device to join the stomach to a healthy segment of the small intestine so there is a passageway (enterostomy) between the stomach and the intestine. One or more small drains may be placed at the surgical site to temporarily allow for drainage of blood and fluid. The abdominal wound is closed in layers. The final skin layer will be closed with a small stapling device. This procedure is now being performed laparoscopically, especially in individuals who are having bariatric surgery



The outcome depends on the underlying disease, the extent of the disease, and the extent of surgery required. Generally, the procedure is successful in providing an alternative conduit (enterostomy) between the stomach and the small intestine.



The most common complications from the procedure include wound infection, leaking at the site where the stomach is joined to the intestine (anastomosis), lung congestion (atelectasis), and bleeding. Less common complications include shock (from bleeding) or cardiac arrest. Late complications include recurrent ulcers, diarrhea (from sugar and carbohydrate intolerance), and iron deficiency anemia.


Nursing considerations

Client Assessment Database

Data depend on the underlying condition necessitating surgery.


Discharge plan

considerations: Assistance with administration of enteral feedings/total parenteral nutrition (TPN) if required, and acquisition of supplies

Refer to section at end of plan for postdischarge considerations.

Nursing Priorities

1. Promote healing and adequate nutritional intake.

2. Prevent complications.

3. Provide information about surgical procedure/prognosis, treatment needs, and concerns.

Discharge Goals

1. Nutritional intake adequate for individual needs.

2. Complications prevented/minimized.

3. Surgical procedure/prognosis, therapeutic regimen, and long-term needs understood.

4. Plan in place to meet needs after discharge.


1. NURSING DIAGNOSIS: risk for imbalanced Nutrition: less than body requirements

Risk factors may include

Restriction of fluids and food

Change in digestive process/absorption of nutrients

Possibly evidenced by

[Not applicable; presence of signs and symptoms establishes an actual diagnosis.]


Nutritional Status (NOC)

Maintain stable weight/demonstrate progressive weight gain toward goal with normalization of laboratory values.

Be free of signs of malnutrition.

2. NURSING DIAGNOSIS: deficient Knowledge [Learning Need] regarding

        procedure, prognosis, treatment, self-care, and discharge needs

May be related to

Lack of exposure/recall

Information misinterpretation

Unfamiliarity with information resources

Possibly evidenced by

Questions, statement of misconception

Inaccurate follow-through of instruction

Development of preventable complications


Knowledge: Disease Process (NOC)

Verbalize understanding of procedure, disease process/prognosis.

Verbalize understanding of functional changes.

Knowledge: Treatment Regimen (NOC)

Identify necessary interventions/behaviors to maintain appropriate weight.

Correctly perform necessary procedures, explaining reasons for actions.


POTENTIAL CONSIDERATIONS following acute hospitalization (dependent on client’s age, physical condition/presence of complications, personal resources, and life responsibilities)

risk for Imbalanced Nutrition—less than body requirements—change in digestive process/absorption of nutrients, early satiety, gastric irritation.

Fatigue—decreased energy production, states of discomfort, increased energy requirements to perform activities of daily living (ADLs).


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