Total Gastrectomy with Radical Systemic Lymphadenectomy (Japanese Procedure)

Abstract

Historically, total gastrectomy with radical lymphadenectomy included distal pancreatectomy and splenectomy and was favored by Brunschwig in 1948. Maruyama modified this procedure by preserving the distal pancreas, so-called pancreas preserving radical total gastrectomy. His initial report was published in Japanese in 1979. Initially he ligated both the splenic artery and vein near their origin, which often caused major congestion of the pancreas tail followed by massive necrosis. The first available English report was published in 1995 and described a modified technique of the original version. There he obtained the splenic vein up to the tip of the pancreas tail to preserve venous return.