[Anatomical basis and clinical research progress of perigastric vagus nerve protection in function-preserving gastric cancer surgery].

The widespread implementation of endoscopic screening and the resulting increase in the detection rate of early gastric cancer have significantly extended patient survival. Consequently, postoperative quality of life, nutritional status, and organ function preservation have become major focal points. In this context, the therapeutic paradigm for gastric cancer has progressively shifted from a singular pursuit of radical oncologic resection to a more balanced approach that incorporates function preservation and quality of life. Concurrently, a deeper understanding of perigastric vagus nerve anatomy has catalyzed research and clinical application regarding the intraoperative identification and preservation of its critical branches, including the hepatic and celiac branches. Accumulating evidence from anatomical, technical, and clinical studies in recent years underscores the clinical value of preserving these specific branches in maintaining postoperative gallbladder function, improving gastric emptying, alleviating bowel symptoms, and accelerating overall functional recovery. However, current data indicate that the clinical benefits of individual branch preservation remain inconsistent and are frequently influenced by surgical modalities, patient selection, and heterogeneous evaluation metrics. This article comprehensively reviews the anatomical foundation, nerve-preserving surgical techniques, and clinical evidence surrounding the perigastric vagus nerve. By integrating current controversies and recent technological advancements, we summarize its application value and provide future perspectives on function-preserving surgery for gastric cancer.