Evaluation of a pylorus-preserving gastrectomy for patients preoperatively diagnosed with early gastric cancer located in the middle third of the stomach

Abstract

Pylorus-preserving gastrectomy patients had fewer postoperative complications than DG patients. The long-term follow-up of these patients will clarify the nutritional and prognostic benefits of PPG.

Oncological outcomes of function-preserving gastrectomy for early gastric cancer: a multicenter propensity score matched cohort analysis comparing pylorus-preserving gastrectomy versus conventional distal gastrectomy

“…This finding is consistent with previous reports [16,20,22]. Delayed gastric emptying is known to be more frequent in PPG patients [21].…”

“…This was presumably attributable to the difference in the pathological stage. Previous studies have consistently reported 5-year OS rates of 95.0-98.0 % after PPG [6][7][8]20]. Among the extremely rare recurrences in both groups, no recurrences in lymph nodes were observed after PPG.…”

“…So far, no randomized controlled trial evaluating the oncological safety of PPG for early gastric cancer has been performed. Previous studies comparing DG and PPG were conducted with little regard to preoperative factors [10,[16][17][18][19][20][21]. In most of these studies, case matching was performed only according to the location of the tumor.…”

“…Delayed gastric emptying is known to be more frequent in PPG patients [21]. The dissection of the infrapyloric vein and the right gastric vein was suggested to cause the longterm retention of the gastric contents following edema of the pyloric cuff [20,27]. The relatively low frequency of stasis in the present study presumably originated from the fact that the specialized gastric surgeons operating in highvolume centers were able to minimize the decrease in gastric motility through the proper preservation of the blood flow to the pyloric cuff.…”

Factors for Postoperative Gallstone Occurrence in Patients with Gastric Cancer: a Meta-analysis

“…How to reduce surgical trauma under the premise of removing tumor have attracted the attention, pyloruspreserving gastrectomy (PPG) has been widely applied (Morita et al, 2008). Pylorus-preserving could improve the postoperative life quality and reduce complications, which have been proved by clinical studies (Ikeguchi et al, 2010). It is usually considered that removing pylorus antrum could cause reduced gastric acid secretion and reduced gastrin levels, which affected bile secretion and resulted in change of bile composition, biliary salt precipitation, and it is prone to gallstone formation.…”