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Wiley InterScience


British Journal of Surgery

British Journal of Surgery

Volume 89 Issue 2, Pages 220 - 224

Published Online: 5 Nov 2002

Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.



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 Original Article
Length of the antral segment in pylorus-preserving gastrectomy
Dr Y. Nakane, T. Michiura, K. Inoue, M. Sato, K. Nakai, K. Yamamichi
Second Department of Surgery, Kansai Medical University, 10-15 Fumizonocho, Moriguchi, Osaka 570, Japan
email: Y. Nakane (nakaney@takii.kmu.ac.jp)

Abstract

Background:
Pylorus-preserving gastrectomy (PPG) has the advantages of preventing dumping syndrome and duodenogastric reflux. However, time was required to reduce symptoms of gastric fullness or to improve food intake after surgery. The aim of this study was to investigate whether the length of the retained antral segment influenced the postoperative symptoms in patients who underwent PPG.

Methods:
Thirty patients with early gastric cancer who underwent PPG were divided into two groups according to the length of the retained antrum. In group 1 (n = 20) the transection was 1·5 cm and in group 2 (n = 10) it was 2·5 cm proximal to the oral edge of the pyloric ring. The subjects were interviewed and examined periodically to assess symptoms, food intake, body-weight and serum nutritional variables. Endoscopy and a radioisotope gastric emptying test were performed 1 year after the operation.

Results:
In group 1 gastric fullness after meals was common, resulting in poor food intake and poor recovery of body-weight. A high incidence of food residue in the remnant stomach was found in group 1. With regard to gastric emptying, seven of 20 patients in group 1 and one of ten in group 2 had a delayed emptying curve 1 year after operation.

Conclusion:
Group 2 was superior to group 1 in terms of postprandial symptoms, food intake, recovery of body-weight and gastric emptying. The length of the retained antrum may play an important role in the motility of the pyloric ring following PPG. © 2002 British Journal of Surgery Society Ltd

Accepted: 27 September 2001

Digital Object Identifier (DOI)

10.1046/j.1365-2168.2002.01984.x  About DOI

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