Complications Following and Supplementary Procedures for a Pancreas-preserving Total Gastrectomy.
10.5230/jkgca.2007.7.1.31
- Author:
Moon Soo LEE
1
;
Gil Ho KANG
;
Gyu Seok CHO
;
Yong Jin KIM
;
Sung Yong KIM
;
Moo Jun BAEK
;
Chang Ho KIM
;
Moo Sik CHO
Author Information
1. Department of Surgery, College of Medicine, Soonchunhyang University, Cheonan, Korea. msslee@schch.co.kr
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Pancreas-preserving total gastrectomy;
Necrosis of pancreatic tail;
Vascular clamp
- MeSH:
Abscess;
Gastrectomy*;
Humans;
Necrosis;
Pancreatic Fistula;
Pancreatic Juice;
Postoperative Complications;
Prevalence;
Retrospective Studies;
Splenic Artery;
Stomach Neoplasms
- From:Journal of the Korean Gastric Cancer Association
2007;7(1):31-37
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: A pancreas-preserving total gastrectomy (PPTG) was introduced to decrease the postoperative complications due to pancreatic resection. However, some complications, such as leakage of pancreatic juice, are still reported. Thus, the purpose of this study was to propose a supplementary procedure based on the results of treatment for gastric cancer at our hospital. MATERIALS AND METHODS: From Jan. 1997 to Dec. 2004, the cases of 141 patients who underwent a PPTG for gastric cancer were reviewed retrospectively. The patients were divided into Group A (38 cases), patients who were treated using a conventional PPTG, and Group B (103 cases), patients who were treated using a new and improved PPTG. Their postoperative complications were compared. RESULTS: No statistically significant differences in clinicopathologic data were noted between the two groups. The comparison of complications showed for groups A and B, respectively, 4 and 0 cases of pancreatic fistula, 1 and 0 cases of intraabdominal abscess, 2 and 0 cases of intraoperative pancreatic necrosis, and 2 and 2 cases of minor leakage. The difference in the prevalence of complications between the two groups was statistically significant (P=0.0001). CONCLUSION: In order to reduce the risk of PPTG-related complications, we used vascular clamps to observe the necrosis of the pancreatic tail before dividing the splenic artery, and this method resulted in a significant decrease in postoperative complications. Thus, we conclude that our use of vascular clamps in a PPTG is a simple and useful method for preventing postoperative complications.
