Postoperative evaluation of pylorus-preserving gastrectomy (PPG) for early gastric cancer

Post-operative function was evaluated in 19 patients undergoing pylorus-preserving gastrectomy (PPG) with preservation of pyloric branch of vagus nerve (PPG-VP), 36 patients undergoing PPG without preservation of that (PPG-NVP), and 30 patients undergoing conventional distal gastrectomy with Billroth I reconstruction (CDG), The gastric emptying time in CDG group was shorter than that in PPG-VP and PPG-NVP groups (p<0.05). Gastric bezoar was more frequently observed in PPG-NVP group than other two groups (p<0.01). Dumping syndrome, reflux gastritis were more frequently observed in CDG group than other two groups (p<0.01). These findings indicated that preservation of pyloric cuff prevented dumping syndrome and reflux gastritis, and additional preservation of pyloric branch of vague nerve reduced stasis, It was suggested that PPG-VP should be used to improve the quality of life in carefully selected patients with early gastric cancer.