Relationship between Gastric Stasis in the Remnant Stomach and Interdigestive Migrating Complex in Patients after Pylorus-Preserving Gastrectomy for Gastric Cancer

Ryouichi Tomita,Shigeru Fujisaki,Kenichi Sakurai,Takeo Azuhata,Yuko Takamoto

doi:10.4236/jct.2018.99055

Abstract

Objectives: The demerit of pylorus-preserving gastrectomy (PPG) is gastric stasis in the remnant stomach (GSRS). We investigated the relationship between postgastrectomy disorder (PGD), especially GSRS, and interdigestive migrating complex (IMC) in PPG patients. Background: The cause of GSRS is still unknown. Therefore, we studied relationship between GSRS and IMC. Methods: 24 PPG patients (16 men and 8 women; mean, 61.2 years) were divided into groups A (12 patients without GSRS) and B (12 patients with GSRS). The relationship between GSRS and IMC was studied. Results: Length of the antral cuff (LAC) was significantly longer in group A than group B (P P = 0.0465, P = 0.0186, respectively). Postprandial abdominal fullness (PAF) was significantly more common in group B than in group A (P = 0.0061). Reflux esophagitis (RE) and body weight loss were found in group B more than in group A. Dumping syndrome was not found in either group. Endoscopic gastritis was found significantly more in group B than in group A (P = 0.0047). Conclusions: In PPG patients with a short LAC, GSRS may occur by the decrease of IMC occurrence.

Highlights

We investigated the relationship between postgastrectomy disorder (PGD), especially gastric stasis in the remnant stomach (GSRS), and interdigestive migrating complex (IMC) in pylorus-preserving gastrectomy (PPG) patients
It is suggested that a common postgastrectomy disorder (PGD) in patients after PPG is postprandial abdominal fullness (PAF) due to gastric stasis in the remnant stomach (GSRS) [1] [2] [3] [4]
From January 2012 to December 2017, 24 patients (16 men and 8 women; aged from 33 to 72 years with a mean age of 61.2 years) with gastric cancer [M, SM, or PM cancer] of N0 underwent PPG with preservation of the vagal nerve. They were divided into 2 groups [Group A, 12 patients without GSRS; Group B, 12 patients with GSRS]

Summary

Introduction

GSRS can be found at a rate of about 32% - 64% at 1 year or more in patients after PPG [5] [6]. In some patients with GSRS after PPG, food consumption becomes insufficient which leads to a deterioration of postoperative QOL. It is reported that GSRS may be caused by impaired gastrointestinal motility [3]

Objectives

Methods

Results

Conclusion