Gastric Emptying After Pylorus-Preserving Gastrectomy in Comparison with Conventional Subtotal Gastrectomy for Early Gastric Carcinoma

Abstract

It is well known that surgical intervention on the stomach will greatly alter gastric function and gastric emptying. In this study, we evaluated the difference in postoperative gastric remnant emptying following pylorus-preserving gastrectomy (PPG) and conventional subtotal gastrectomy (CDG) using sulfamethizole capsule food. The subjects comprised 18 patients who underwent PPG and 23 who underwent CDG for early gastric carcinoma. While delayed gastric emptying was observed early after PPG, 1 year after PPG it was markedly accelerated compared with that measured in the early postoperative period. However, it was slower than that in the CDG patients. On the other hand, rapid gastric emptying was observed early after CDG and did not change with time. These findings stress that although PPG results in stasis in the early postoperative period, it seems to prevent unduly rapid emptying.

Nutritional Assessment of Patients After Pylorus-Preserving Gastrectomy for Early Gastric Cancer

“…However, our present data and other previous studies demonstrated, with postoperative endoscopy, a large amount of residual food in the gastric remnant in PPG patients [18,19]. Nishikawa et al [20] demonstrated by scintigraphy that gastric emptying was delayed in PPG patients compared to DG patients after vagal pyloric branch preservation.…”

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

“…11,12 However, the frequency of postprandial symptoms after PPG was reduced during the long follow-up periods, and food intake increased in the 2 years following the operation. [12][13][14] Hotta et al 15 reported the nutritional status and serum albumin and hemoglobin levels to be better in PPG patients than in DG patients. Park et al 11 reported that gastritis, bile refl ux, and gallbladder stones were observed in DG patients, but not in PPG patients.…”

Length of the antral segment in pylorus-preserving gastrectomy

“…As a result, a considerable amount of time was necessary before symptoms of gastric fullness became diminished and food intake improved 6 . Other authors have also reported a high incidence of gastric fullness after meals and long-term retention of food in the residual stomach soon after PPG 7,8 . This feeling of gastric fullness was thought to be associated with delayed gastric emptying due to motility disturbances, although the transection line was made at 1´5 cm from the proximal edge of the pyloric ring.…”