Updates in Surgery

, Volume 65, Issue 2, pp 95–101 | Cite as

Bursectomy in gastric cancer surgery: surgical technique and operative safety

  • Konstantinos Blouhos
  • Konstantinos A. Boulas
  • Anestis Hatzigeorgiadis
Original Article


Although there is little evidence that bursectomy has clinical benefit, its continuing practice imposes evaluation of bursectomy-related adverse effects, especially pancreatic fistula and intestinal obstruction. The aims of this study were to provide a detailed description of the technique of bursectomy as standardized by the authors and determine if extended surgery for gastric cancer with additional bursectomy can be performed safely in Western population. A total of 72 consecutive patients of median age 76.4 years and mean ASA score grade 2.1, who submitted to D2 or D2+ gastrectomy with additional bursectomy for gastric adenocarcinoma, were prospectively studied. Bursectomy was associated with a median additional operative time of 41 min and a median additional blood loss of 65 ml. The post-operative morbidity rate was 19.4 %. Among various adverse events, pancreatic fistula was observed in three patients (4.2 %) and intestinal obstruction was observed in eight patients (11.1 %) including two cases of delayed gastric emptying, one case of afferent loop syndrome, one case of early postoperative adhesions and four cases of prolonged postoperative ileus. The in-hospital mortality rate was 1.4 %. D2 or D2+ gastrectomy with additional bursectomy can be safely performed in Western patients. Although the incidence of pancreatic fistula that we reported was low, the incidence of bursectomy-related intestinal obstruction was high and should always be kept in mind when performing extended surgery for gastric cancer.


Gastrectomy D2+ lymphadenectomy Bursectomy Pancreatic fistula Intestinal obstruction 


Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Italia 2013

Authors and Affiliations

  • Konstantinos Blouhos
    • 1
  • Konstantinos A. Boulas
    • 1
  • Anestis Hatzigeorgiadis
    • 1
  1. 1.Department of General SurgeryGeneral Hospital of DramaDramaGreece

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