World Journal of Surgery

, 31:2335 | Cite as

Laparoscopy-assisted Pylorus-preserving Gastrectomy: Preservation of Vagus Nerve and Infrapyloric Blood Flow Induces Less Stasis

  • Souya Nunobe
  • Naoki HikiEmail author
  • Tetsu Fukunaga
  • Masanori Tokunaga
  • Shigekazu Ohyama
  • Yasuyuki Seto
  • Toshiharu Yamaguchi



Pylorus-preserving gastrectomy (PPG) prevents postprandial symptoms; however, delayed gastric retention due to aberrant pylorus function can occur during the early postoperative period. This study aimed to establish a stasis-less PPG procedure with preservation of the vagal nerve and blood flow to the pyloric cuff, and to apply the technique for laparoscopy-assisted PPG.


Ninety patients with T1 gastric cancer located in the middle third of the stomach were enrolled in this study for surgery from January 2003 to March 2006, undergoing either laparoscopy-assisted PPG (LAPPG; 39 patients) or conventional PPG (CPPG; 51 patients). Operative and early postoperative outcomes were compared between the two groups.


Relatively low rates of gastric stasis were observed in both the LAPPG (8%) and CPPG (6%) groups. Estimated blood loss in LAPPG (65.4 ± 12.3 ml) patients was significantly lower than in the CPPG group (160.7 ± 19.6 ml) (p < 0.001), and the total number of dissected lymph nodes was significantly greater in the LAPPG group (36.2 ± 1.8) than in the CPPG group (29.0 ± 1.3) (p = 0.001).


A PPG procedure with less postoperative stasis and adequate lymph node retrieval was established and applied successfully in laparoscopy-assisted surgery.


Gastric Cancer Early Gastric Cancer Vagal Nerve Left Gastric Artery Gastric Retention 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors thank Mr. Leon Sakuma for the illustrations presented in this article.


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Copyright information

© Société Internationale de Chirurgie 2007

Authors and Affiliations

  • Souya Nunobe
    • 1
  • Naoki Hiki
    • 1
  • Tetsu Fukunaga
    • 1
  • Masanori Tokunaga
    • 1
  • Shigekazu Ohyama
    • 1
  • Yasuyuki Seto
    • 1
  • Toshiharu Yamaguchi
    • 1
  1. 1.Department of SurgeryCancer Institute HospitalTokyoJapan

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