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Langenbeck's Archives of Surgery

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01-09-2005 | How To Do It

Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches

Authors: Naoki Hiki, Michio Kaminishi

Published in: Langenbeck's Archives of Surgery | Issue 5/2005

Abstract

Background and aims

Pylorus-preserving gastrectomy (PPG) has been accepted as a function-preserving procedure for early gastric cancer for the prevention of postgastrectomy syndrome. In general, PPG procedures have not included suprapyloric lymph node dissection to preserve the pyloric branch of the vagal nerve and the right gastric artery. The aim of this article is to describe procedures for PPG. The technique of laparoscopy-assisted pylorus-preserving gastrectomy (LAPPG) is also introduced because PPG is an ideal application for laparoscopic surgery.

Patients/methods

Between September 2000 and September 2004, we performed 37 cases of conventional PPG and further 73 cases of LAPPG. In these patients, PPG including complete lymph node dissection around the remnant pyloric cuff was performed. For this purpose, it is recommended that the blood flow to the pyloric cuff be maintained by preserving the infrapyloric artery.

Results

All the patients showed good postoperative recovery, and no intraoperative or postoperative major complications were observed. No sign of recurrence was found in these 110 patients, and none of them demonstrated dumping syndrome.

Conclusion

The procedures of both PPG and LAPPG are technically feasible and have an important role in the surgical management of early gastric cancer in terms of better quality of postoperative life, even with lymphadenectomy including combined suprapyloric lymph node dissection and right gastric artery division.

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Title: Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches
Authors: Naoki Hiki
Michio Kaminishi
Publication date: 01-09-2005
Publisher: Springer-Verlag
Published in: Langenbeck's Archives of Surgery / Issue 5/2005
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-005-0573-4

At a glance: The STEP trials

Springer Medicine

Pylorus-preserving gastrectomy in gastric cancer surgery—open and laparoscopic approaches

Abstract

Background and aims

Patients/methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background and aims

Patients/methods

Results

Conclusion

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