Skip to main content
SpringerLink
Log in

Outcomes after Pylorus-preserving Gastrectomy for Early Gastric Cancer: A Prospective Multicenter Trial

  • Original Scientific Reports
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

The aim of the present study was to compare in a prospective, multicenter trial the results early and late after pylorus-preserving gastrectomy (PPG) versus conventional distal gastrectomy (CDG) with Billroth I anastomosis for early gastric cancer. Eighty-one patients with early gastric cancer were randomized and then underwent either PPG or CDG. Duration of operation, intraoperative blood loss, days until removal of the nasogastric tube, days until start of oral intake, and decrease in body weight were studied as parameters for outcomes early after the surgery. Late results were studied in patients followed for longer than 3 years. Change in body weight, status of oral intake, symptoms suggesting early dumping syndrome, and overall satisfaction were addressed in the questionnaire. The presence of gallstones was examined with ultrasonography. There were no differences in early results between PPG and CDG. The incidence of early dumping syndrome was lower in PPG (8%) than in CDG (33%). Other late results including the incidence of gallstones were not different between the 2 groups. These results indicate that PPG is as safe as CDG and has an advantage in terms of early dumping syndrome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. T Maki T Shiratori T Hatafuku et al. (1967) ArticleTitlePylorus-preserving gastrectomy as an improved operation for gastric ulcer Surgery 61 838–845 Occurrence Handle1:STN:280:CCiC28rgtFA%3D Occurrence Handle5338114

    CAS  PubMed  Google Scholar 

  2. T Sekine T Sato T Maki et al. (1975) ArticleTitlePylorus-preserving gastrectomy for gastric ulcer—One- to nine-year follow-up study Surgery 77 92–99 Occurrence Handle1:STN:280:CSqD28jnvFI%3D Occurrence Handle1109520

    CAS  PubMed  Google Scholar 

  3. I Sasaki K Fukushima H Naito et al. (1992) ArticleTitleLong-term results of pylorus-preserving gastrectomy for gastric ulcer Tohoku J. Exp. Med. 168 539–548 Occurrence Handle1:STN:280:ByyA3MfisFM%3D Occurrence Handle1306602

    CAS  PubMed  Google Scholar 

  4. K Sawai T Takahashi H Suzuki (1994) ArticleTitleNew trends in surgery for gastric cancer in Japan J. Surg. Oncol. 56 221–226 Occurrence Handle1:STN:280:ByuA3srivFM%3D Occurrence Handle8057646

    CAS  PubMed  Google Scholar 

  5. I Sasaki K Shiiba H Naito et al. (1996) ArticleTitlePylorus-preserving gastrectomy for early gastric cancer J. Jap. Surg. Society 97 291–296 Occurrence Handle1:STN:280:BymB2Mzoslw%3D

    CAS  Google Scholar 

  6. KE Hall GR Greenberg TY El-Sharkawy et al. (1984) ArticleTitleRelationship between porcine motilin-induced migrating motor complex-like activity, vagal integrity, and endogenous motilin release in dogs Gastroenterology 87 76–85 Occurrence Handle1:CAS:528:DyaL2cXks1KntLg%3D Occurrence Handle6724277

    CAS  PubMed  Google Scholar 

  7. Japanese Gastric Cancer Association. Japanese Classification of Gastric Carcinoma, 13th edition, Tokyo, Kanehara, 1999.

  8. Japanese Gastric Cancer Association. Igan Tiryou Guideline. Tokyo, Kanehara, 2001

  9. M Kodama K Koyama T Chida et al. (1995) ArticleTitleEarly postoperative evaluation of pylorus-preserving gastrectomy for gastric cancer World J. Surg. 19 456–461 Occurrence Handle1:STN:280:ByqA28nitFI%3D Occurrence Handle7639006

    CAS  PubMed  Google Scholar 

  10. T Imada Y Rino M Takahashi et al. (1998) ArticleTitlePostoperative functional evaluation of pylorus-preserving gastrectomy for early gastric cancer compared with conventional distal gastrectomy Surgery 123 165–170 Occurrence Handle10.1067/msy.1998.84176 Occurrence Handle1:STN:280:DyaK1c7kt1Cjsw%3D%3D Occurrence Handle9481402

    Article  CAS  PubMed  Google Scholar 

  11. T Hotta K Taniguchi Y Kobayashi et al. (2001) ArticleTitlePostoperative evaluation of pylorus-preserving procedures compared with conventional distal gastrectomy for early gastric cancer Surg. Today 31 774–779 Occurrence Handle10.1007/s005950170046 Occurrence Handle1:STN:280:DC%2BD3MnhtF2htw%3D%3D Occurrence Handle11686554

    Article  CAS  PubMed  Google Scholar 

  12. D Zhang S Shimoyama M Kaminishi (1998) ArticleTitleFeasibility of pylorus-preserving gastrectomy with a wider scope of lymphadenectomy Arch. Surg. 133 993–997 Occurrence Handle10.1001/archsurg.133.9.993 Occurrence Handle1:STN:280:DyaK1cvitVarsQ%3D%3D Occurrence Handle9749854

    Article  CAS  PubMed  Google Scholar 

  13. T Nakabayashi E Mochiki M Garcia et al. (2002) ArticleTitlePyloric motility after pylorus-preserving gastrectomy with or without the pyloric branch of the vagus nerve World J. Surg. 26 577–583 Occurrence Handle10.1007/s00268-001-0270-6 Occurrence Handle12098048

    Article  PubMed  Google Scholar 

  14. H Isozaki K Okajima E Momura et al. (1996) ArticleTitlePostoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer Br. J. Surg. 83 266–269 Occurrence Handle10.1046/j.1365-2168.1996.02093.x Occurrence Handle1:STN:280:BymB2cnpvVM%3D Occurrence Handle8689185

    Article  CAS  PubMed  Google Scholar 

  15. Y Nakane K Akehira K Inoue et al. (2000) ArticleTitlePostoperative evaluation of pylorus-preserving gastrectomy for early gastric cancer Hepatogastroenterology 47 590–595 Occurrence Handle1:STN:280:DC%2BD3c3ltFynsw%3D%3D Occurrence Handle10791245

    CAS  PubMed  Google Scholar 

  16. C Shibata I Sasaki H Naito et al. (1997) ArticleTitleDuodenal but not gastric transection disturbs motility of the sphincter of Oddi in the dog World J. Surg. 21 191–194 Occurrence Handle10.1007/s002689900214 Occurrence Handle1:STN:280:ByiC2M3jsVU%3D Occurrence Handle8995077

    Article  CAS  PubMed  Google Scholar 

  17. H Naito C Shibata N Ohtani et al. (2002) ArticleTitlePylorus-preserving gastrectomy: effect on resistance through the sphincter of Oddi compared to conventional distal gastrectomy in dogs World J. Surg. 26 602–607 Occurrence Handle10.1007/s00268-001-0276-0 Occurrence Handle12098054

    Article  PubMed  Google Scholar 

  18. T Nabae S Takahata H Konomi et al. (2001) ArticleTitleEffect of prepyloric transection and anastomosis on sphincter of Oddi cyclic motility in conscious dogs J. Gastroenterol. 36 530–537 Occurrence Handle10.1007/s005350170055 Occurrence Handle1:STN:280:DC%2BD3Mvns1ekug%3D%3D Occurrence Handle11519831

    Article  CAS  PubMed  Google Scholar 

  19. A Enjoji K Ura T Ozeki et al. (1996) ArticleTitleCyclic motor activity of the gallbladder maintained in a pylorus-preserving gastrectomy in dogs Surg. Today 26 489–495 Occurrence Handle1:STN:280:BymH3sjot1Q%3D Occurrence Handle8840429

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments.

The authors thank Dr. Michael G. Sarr, Division of Gastroenterologic and General Surgery, Mayo Clinic and Foundation, Rochester, Minnesota, for reviewing this article.

Author information

Authors and Affiliations

  1. Department of Surgery, Tohoku University School of Medicine, Seiryo-machi, 980-8574, Aoba-ku, Sendai, Japan

    Chikashi Shibata M.D., Ken-ichí Shiiba M.D., Yuji Funayama M.D., Seiichi Ishii M.D., Kouhei Fukushima M.D., Takayuki Mizoi M.D., Kaori Koyama M.D., Koh Miura M.D., Seiki Matsuno M.D. & Iwao Sasaki M.D.

  2. Department of Surgery, South Miyagi Medical Center, 38-1 Aza-nishi, 989-1253, Ogawara, Miyagi, Japan

    Hiroo Naito M.D.

  3. Department of Surgery, Ichinoseki Hospital, 3-36 Ohte-machi, 021-0884, Ichinoseki, Iwate, Japan

    Eiichi Kato M.D.

  4. Department of Surgery, Tohoku Kosei-Nenkin Hospital, 1-12-1 Fukumuro, 983-0005 Miyagino-ku, Sendai, Japan

    Tsuyohiko Honda M.D.

  5. Department of Surgery, Japanese Red Cross Sendai Hospital, 2-43-3 Yagiyama-honchou, 982-0801, Tihaku-ku, Sendai, Japan

    Satoshi Momono M.D.

  6. Department of Surgery, Tohoku Rosai Hospital, 4-3-21 Dainohara, 981-0911, Aoba-ku, Sendai, Japan

    Akio Ouchi M.D.

  7. Department of Surgery, Fukushima Rosai Hospital, 3 Uchigou Tsuzuri-cho Numajiri, 973-8403, Iwaki, Fukushima, Japan

    Yoshikazu Ashino M.D.

  8. Department of Surgery, Mito Kyodo General Hospital, 3-2-7 Miya-machi, 310-0015, Mito, Ibaragi, Japan

    Yoshinobu Takahashi M.D.

  9. Department of Surgery, Miyagi Cancer Center, 47-1 Medeshima Shiote Aza-nodaya, 981-1239, Natori, Miyagi, Japan

    Tsuneaki Fujiya M.D.

  10. Department of Surgery, Mizusawa City Hospital, 3-1 Ohte-machi, 023-0053, Mizusawa, Iwate, Japan

    Akihiro Iwatsuki M.D.

Authors
  1. Chikashi Shibata M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ken-ichí Shiiba M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yuji Funayama M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Seiichi Ishii M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kouhei Fukushima M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Takayuki Mizoi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kaori Koyama M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Koh Miura M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Seiki Matsuno M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Hiroo Naito M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Eiichi Kato M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Tsuyohiko Honda M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Satoshi Momono M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Akio Ouchi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Yoshikazu Ashino M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  16. Yoshinobu Takahashi M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  17. Tsuneaki Fujiya M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  18. Akihiro Iwatsuki M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  19. Iwao Sasaki M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chikashi Shibata M.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shibata, C., Shiiba, Ki., Funayama, Y. et al. Outcomes after Pylorus-preserving Gastrectomy for Early Gastric Cancer: A Prospective Multicenter Trial. World J. Surg. 28, 857–861 (2004). https://doi.org/10.1007/s00268-004-7369-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-004-7369-5

Keywords

Search

Navigation