Feasibility of preserving the remnant stomach during distal pancreatectomy after distal gastrectomy
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ORIGINAL ARTICLE
Feasibility of preserving the remnant stomach during distal pancreatectomy after distal gastrectomy Jiro Kimura1 · Takehiro Okabayashi1 · Kenta Sui1 · Takatsugu Matsumoto1 · Takahiro Murokawa1 · Jun Iwata2 · Sojiro Morita3 · Yasuhiro Shimada4 Received: 17 February 2020 / Accepted: 19 April 2020 © Springer Nature Singapore Pte Ltd. 2020
Abstract Purpose The safety and feasibility of preserving the remnant stomach during distal pancreatectomy (DP) in patients who have undergone distal gastrectomy (DG) remains unclear. Methods A retrospective review of a prospectively maintained database was performed to identify patients who underwent DP. A propensity score-matched analysis was performed to match post-DG patients with control patients. Results Among the 226 patients included in this study, 9 DP patients who had a history of DG were studied (4.0%). These nine patients in the DG group were matched to 45 patients in the control group. There were no significant differences in the incidence of postoperative morbidities, including postoperative pancreatic fistula rate or stomach-related complications. The hemoglobin A1C (HbA1c) levels in the DG group after surgery decreased to the normal range. Conclusion Our study suggested that the remnant stomach may be safely preserved when performing DP in patients with a history of DG with respect to short-term morbidities. However, there are some concerns about the long-term nutritional status in patients with a history of DG. Keywords Distal pancreatectomy · Distal gastrectomy · Stomach-related complications
Introduction Distal gastrectomy (DG) and distal pancreatectomy (DP) are standard surgical procedures for treating benign and malignant diseases located at the distal side of the stomach and the pancreatic body or tail, respectively. Recent advances in surgical techniques and perioperative management have
made both DG and DP safe procedures of curative treatment [1, 2]. When patients who have previously undergone DG develop distal pancreatic tumors, DP is also considered if those tumors are curatively resectable. However, whether the remnant stomach can be safely preserved without ischemic complications or if it should be removed simultaneously during DP, as the main blood supply of the remnant stomach
* Takehiro Okabayashi [email protected]
Yasuhiro Shimada [email protected]
Jiro Kimura [email protected]
1
Kenta Sui [email protected]
Department of Gastroenterological Surgery, Kochi Health Sciences Center, 2125‑1 Ike, Kochi, Kochi 781‑8555, Japan
2
Takatsugu Matsumoto t‑[email protected]
Department of Diagnostic Pathology, Kochi Health Sciences Center, 2125‑1 Ike, Kochi, Kochi 781‑8555, Japan
3
Takahiro Murokawa [email protected]
Department of Radiology, Kochi Health Sciences Center, 2125‑1 Ike, Kochi, Kochi 781‑8555, Japan
4
Department of Clinical Oncology, Kochi Health Sciences Center, 2125‑1 Ike, Kochi, Kochi 781‑8555, Japan
Jun Iwata [email protected] Sojiro Morita sojiro_morit
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