Clinical Outcome of Pylorus‐preserving Gastrectomy in Gastric Cancer in Comparison with Conventional Distal Gastrectomy with Billroth I Anastomosis
- 7 February 2008
- journal article
- research article
- Published by Wiley in World Journal of Surgery
- Vol. 32 (6), 1029-1036
- https://doi.org/10.1007/s00268-007-9441-4
Abstract
Pylorus-preserving gastrectomy (PPG) was originally a treatment option in gastric ulcer surgery and is now being performed as a limited surgery in some early gastric cancer cases. This study was designed to evaluate the postoperative functional characteristics of PPG versus conventional distal gastrectomy with Billroth I anastomosis (BI). Patients who underwent PPG (study group) between November 1999 and April 2003 were enrolled and BI patients (control group) were matched for number, gender, age, weight, height, stage, and follow-up period. We evaluated postprandial symptoms and nutritional status. Gastric emptying studies with a 99mTc gamma camera, follow-up endoscopies with random biopsies of remnant gastric mucosa to evaluate bile reflux gastritis, and ultrasonography to detect gallbladder stones were performed. Recurrence and survival also were investigated. Twenty-two PPG patients (study group) and 17 BI patients (control group) were enrolled. Overall modified Visick scores of postprandial symptoms were lower in PPG patients than in BI patients (0.9 ± 0.7 vs. 2.3 ± 1.4; p = 0.018). Gastric emptying was delayed in PPG patients versus BI patients for solids (p < 0.05). Moderate gastritis, bile reflux, and gallbladder stone were observed only in BI patients. Remnant stomach pathologic findings corresponding to bile reflux gastritis in the two groups were similar, except for Helicobacter pylori colonization. No recurrence occurred in either group (mean follow-up period = 41 ± 9.5 months). PPG patients had fewer subjective postprandial symptoms than BI patients. The present study also suggests that PPG has advantages over BI in terms of the avoidance of bile reflux and gallbladder stones.Keywords
This publication has 30 references indexed in Scilit:
- Outcomes after Pylorus‐preserving Gastrectomy for Early Gastric Cancer: A Prospective Multicenter TrialWorld Journal of Surgery, 2004
- Inflammation of the gastric remnant after gastrectomy: mucosal erythema is associated with bile reflux and inflammatory cellular infiltration is associated with Helicobacter pylori infectionThe Esophagus, 2004
- The endoscopic evaluation of gastritis, gastric remnant residue, and the incidence of secondary cancer after pylorus-preserving and transverse gastrectomiesGastric Cancer, 2004
- Endoscopic evaluation of the remnant stomach after gastrectomy: proposal for a new classificationGastric Cancer, 2002
- Postoperative functional evaluation of pylorus-preserving gastrectomy for early gastric cancer compared with conventional distal gastrectomySurgery, 1998
- Postoperative evaluation of pylorus-preserving gastrectomy for early gastric cancerBritish Journal of Surgery, 1996
- Role of the proximal and distal stomach in mixed solid and liquid meal emptying.Gut, 1991
- Reflux gastritis: distinct histopathological entity?Journal of Clinical Pathology, 1986
- Several Standard Elective Operations for Duodenal UlcerAnnals of Surgery, 1979