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Feasibility of preserving the remnant stomach during distal pancreatectomy after distal gastrectomy

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Abstract

Purpose

The safety and feasibility of preserving the remnant stomach during distal pancreatectomy (DP) in patients who have undergone distal gastrectomy (DG) remains unclear.

Methods

A retrospective review of a prospectively maintained database was performed to identify patients who underwent DP. A propensity score-matched analysis was performed to match post-DG patients with control patients.

Results

Among the 226 patients included in this study, 9 DP patients who had a history of DG were studied (4.0%). These nine patients in the DG group were matched to 45 patients in the control group. There were no significant differences in the incidence of postoperative morbidities, including postoperative pancreatic fistula rate or stomach-related complications. The hemoglobin A1C (HbA1c) levels in the DG group after surgery decreased to the normal range.

Conclusion

Our study suggested that the remnant stomach may be safely preserved when performing DP in patients with a history of DG with respect to short-term morbidities. However, there are some concerns about the long-term nutritional status in patients with a history of DG.

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Data availability

All data generated or analyzed during this study are included in the published article.

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Acknowledgements

We would like to thank Editage (www.editage.com) for the English language editing.

Funding

This work was supported by Kochi Organization for Medical Reformation and Renewal grants.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125-1 Ike, Kochi, Kochi, 781-8555, Japan

    Jiro Kimura, Takehiro Okabayashi, Kenta Sui, Takatsugu Matsumoto & Takahiro Murokawa

  2. Department of Diagnostic Pathology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, Kochi, 781-8555, Japan

    Jun Iwata

  3. Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, Kochi, 781-8555, Japan

    Sojiro Morita

  4. Department of Clinical Oncology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, Kochi, 781-8555, Japan

    Yasuhiro Shimada

Authors
  1. Jiro Kimura
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  2. Takehiro Okabayashi
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  3. Kenta Sui
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  4. Takatsugu Matsumoto
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  5. Takahiro Murokawa
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Contributions

JK drafted the manuscript. TO edited the article. KS, TM, and TM performed the administrative, technical, and material support. JI made the pathologic diagnosis. TO, SM, and YS provided academic consideration. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Takehiro Okabayashi.

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Conflict of interest

The authors declare that they have no competing interests.

Ethics approval

This study was approved by the Ethics Committee of Kochi Health Sciences Center.

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Kimura, J., Okabayashi, T., Sui, K. et al. Feasibility of preserving the remnant stomach during distal pancreatectomy after distal gastrectomy. Surg Today 50, 1394–1401 (2020). https://doi.org/10.1007/s00595-020-02016-4

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  • DOI: https://doi.org/10.1007/s00595-020-02016-4

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