Since a high proportion of early gastric cancers are diagnosed in Japan and Korea, surgical strategies have been developed to preserve postoperative function without oncological compromise. Pylorus-preserving gastrectomy (PPG) in this manner is a good option for clinically early gastric cancers of the middle portion of the stomach. When preserving a substantial proportion of the stomach with sufficient blood supply, including junctional area and pylorus, the postoperative course is expected to improve in comparison to distal gastrectomy. As long-term outcomes suggest its oncological safety, recent prospective trials aim for nutritional aspects and quality of life in the follow-up period. Postoperative malfunction of the pylorus can compromise the functional outcome of PPG significantly, but there are several technical aspects to be considered during surgery in order to avoid complications related to this issue. This chapter summarizes the background of the PPG operation and explains the resection and different approaches for reconstruction in a step-by-step manner.
Pylorus-preserving gastrectomy Laparoscopic gastrectomy Robotic gastrectomy Gastric cancer Minimally-invasive surgery Partial gastrectomy
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