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Gastric Cancer

, Volume 21, Issue 5, pp 864–870 | Cite as

Clinical outcomes of intraoperative manual dilatation of pylorus in pylorus-preserving gastrectomy: a retrospective analysis

  • Chun-Chao Zhu
  • Tae-Han Kim
  • Felix Berlth
  • Shin-Hoo Park
  • Yun-Suhk Suh
  • Seong-Ho Kong
  • Hyuk-Joon Lee
  • Hui Cao
  • Han-Kwang Yang
Original Article
  • 143 Downloads

Abstract

Background

Delayed gastric emptying is one of the most disturbing complications of pylorus-preserving gastrectomy (PPG) and it increases hospital stay. We investigated the clinical outcome of intraoperative manual dilatation of the pylorus as a preventive method of pyloric spasm after PPG.

Materials and methods

We reviewed gastric cancer patients who underwent PPG between January 2014 and December 2016 at Seoul National University Hospital by a single surgeon. During operation, manual dilatation (MD) was performed after laparoscopic dissection and gastric resection by mini-laparotomy. Pyloric stenosis was diagnosed by the finding of severe narrowing in pylorus on upper gastrointestinal series (UGIS), if patients suffered from postprandial abdominal fullness and discomfort. Patient’s characteristics, surgical data and complication data were reviewed and compared between the groups (MD vs non-MD).

Results

232 patients were included in this study. 93 patients underwent manual dilatation (40.1%). The overall complication rate was 12.9% in the MD group and 18.7% in the non-MD group (p = 0.242). Mean postoperative stay was 10.0 ± 5.8 in the MD group versus 10.9 ± 8.4 in the non-MD group (p = 0.304). Only one case suffered pylorus stenosis in the MD group (1.1%) but there were twelve cases seen in the non-MD group (8.6%), which reflects a significant difference (p = 0.019).

Conclusion

Simple intraoperative manual dilatation of pylorus may provide prevention from pyloric stenosis caused by pyloric spasms for patients who undergo PPG.

Keywords

Manual dilatation Pylorus-preserving gastrectomy Pyloric stenosis 

Notes

Compliance with ethical standards

Ethics statement

This retrospective study was conducted ethically in accordance with the Ethical Principles for Medical Research Involving Human Subjects, as outlined in The Declaration of Helsinki after approval of the institutional review board of Seoul National University Hospital (No. 1706-176-864). Informed consent was waved by the institutional review board based on its decision that the risk of this study to the patient is minimal.

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

10120_2018_814_MOESM1_ESM.docx (90 kb)
Supplementary material 1 (DOCX 89 kb)

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  • Chun-Chao Zhu
    • 1
    • 2
  • Tae-Han Kim
    • 3
  • Felix Berlth
    • 4
  • Shin-Hoo Park
    • 1
  • Yun-Suhk Suh
    • 1
  • Seong-Ho Kong
    • 1
  • Hyuk-Joon Lee
    • 1
    • 5
  • Hui Cao
    • 2
  • Han-Kwang Yang
    • 1
    • 5
  1. 1.Department of SurgerySeoul National University HospitalSeoulSouth Korea
  2. 2.Department of Gastrointestinal SurgeryRenji Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
  3. 3.Department of SurgeryGyeongsang National University HospitalJinjuSouth Korea
  4. 4.Department of General, Visceral and Cancer SurgeryUniversity Hospital CologneCologneGermany
  5. 5.Cancer Research InstituteSeoul National UniversitySeoulSouth Korea

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