Is preservation of the celiac branch of the vagal nerve effective in preventing stasis following pylorus-preserving gastrectomy?

BACKGROUND/AIMS: Although pylorus-preserving gastrectomy (PPG) is performed as a function preserving surgery, patients sometimes suffer from postoperative stasis of the gastric contents after the procedure. Preservation of blood flow and both celiac and pyloric branches of the vagal nerve may decrease the incidence of the stasis.

METHODOLOGY: Patients who underwent PPG at the Cancer Institute Hospital between April 2005 and December 2007 were included in the study. Early surgical results and the incidence of stasis were investigated and compared between patients in whom the celiac branch had been preserved (PPG-CBP group) and those in whom it had not (PPG-nCBP group).

RESULTS

Patients in the PPG-nCBP group had a higher body mass index than patients in the PPG-CBP group (23.9 vs. 22.3 kg/m2; p=0.004), as well as a longer operation time (249.3 vs. 227.0 min; p=0.010). There was no significant difference in the incidence of stasis between the groups (13% vs. 8%; p=0.523).

CONCLUSIONS

There was no correlation between preservation of the celiac branch and the incidence of stasis in the first 30 days after PPG. A large randomized control trial investigating both short- and long-term outcomes after PPG is required to elucidate the primary cause of postoperative stasis.