Postoperative functional evaluation of pylorus-preserving gastrectomy for early gastric cancer compared with conventional distal gastrectomy

被引:84
作者
Imada, T [1 ]
Rino, Y [1 ]
Takahashi, M [1 ]
Suzuki, M [1 ]
Tanaka, J [1 ]
Shiozawa, M [1 ]
Kabara, K [1 ]
Hatori, S [1 ]
Ito, H [1 ]
Yamamoto, Y [1 ]
Amano, T [1 ]
机构
[1] Yokohama City Univ, Sch Med, Dept Surg 1, Minami Ku, Yokohama, Kanagawa 232, Japan
关键词
D O I
10.1016/S0039-6060(98)70254-5
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background. Malnutrition, gallbladder dysfunction, dumping syndrome, reflux esophagitis, and gastritis of the remnant stomach are unfavorable sequelae in patients undergoing gastrectomy. Operative procedures should be improved to ensure such patients a satisfactory quality of life. Methods. After operation, gallbladder function, reflux gastritis, gastric emptying and caloric intake were evaluated in 20 patients with early gastric cancer undergoing pylorus-preserving gastrectomy (PPG) and 25 patients undergoing conventional distal gastrectomy (CDG). Results. The resting gallbladder area increased significantly after CDG. In contrast, after PPG the gallbladder area showed no significant change and the contraction rate decreased slightly. After CDG, emptying was much more rapid for the first 30 minutes after ingestion of a meal. Although delayed emp tying was observed early after PPG, the rate of emptying increased with time. Gastric pH was lower and gastric mucosal injury was milder in patients undergoing PPG. These results are attributed to preserved pyloric function. The caloric intake and changes in body weight after operation were similar in both the CDG and PPG groups. Conclusions. PPG has advantages over CDC in terms of gallbladder function, the condition of the remnant stomach, and gastric emptying PPG should be used in carefully selected patients with early gastric cancer to improve their quality of life.
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页码:165 / 170
页数:6
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