Comparison between laparoscopic pylorus-preserving gastrectomy and laparoscopic distal gastrectomy for overweight patients with early gastric cancer

Hwa-Jeong Lee; Khalid Mohammed Alzahrani; Sa-Ra Kim; Ji-Hyun Park; Yun-Suhk Suh; Do-Joong Park; Hyuk-Joon Lee; Han-Kwang Yang; Seong-Ho Kong

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저자정보: Hwa-Jeong Lee (Seoul National University Hospital) Khalid Mohammed Alzahrani (Seoul National University Hospital) Sa-Ra Kim (Seoul National University Hospital) Ji-Hyun Park (Seoul National University Hospital) Yun-Suhk Suh (Seoul National University Hospital) Do-Joong Park (Seoul National University Hospital) Hyuk-Joon Lee (Seoul National University Hospital) Han-Kwang Yang (Seoul National University Hospital) Seong-Ho Kong (Seoul National University Hospital)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.104 No.1

발행연도: 2023.1

수록면: 18 - 26 (9page)

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Purpose: Laparoscopic pylorus-preserving gastrectomy (LPPG) has a nutritional advantage over laparoscopic distal gastrectomy (LDG), however, may be less beneficial in overweight patients in terms of weight loss. The purpose of this study was to compare LPPG and LDG in overweight patients with early gastric cancer.
Methods: Clinicopathologic data of overweight patients (body mass index [BMI], ≥25 kg/m2) who underwent LPPG (n = 63) or LDG (n = 183) in 2016–2018 were retrospectively reviewed. In the LDG group, patients with Billroth-II anastomosis were separately grouped (LDG B-II, n = 66). Changes in BMI, hemoglobin, albumin, and total protein were compared among groups.
Results: Changes in BMI were not significant different among groups. The LPPG group had significantly higher albumin than the LDG group at postoperative 6 months and 1 year. The LPPG group had higher total protein than the LDG group at postoperative 2 years. The LPPG group had a higher complication rate of Clavien-Dindo classification III or higher (20.6%) than the LDG group (8.2%, P = 0.007). However, after excluding pyloric stenosis, there was no significant difference among groups (LPPG vs. LDG, P = 0.290; LPPG vs. LDG B-II, P = 0.921).
Conclusion: LPPG and LDG groups showed similar weight loss. However, the LPPG group had higher albumin and protein levels than the LDG group of overweight patients. Thus, it is not necessary to select LDG only for weight loss. LPPG may be selected as one option due to its potential nutritional benefit when pyloric stenosis is properly managed.

#Gastrectomy #Overweight #Stomach neoplasms

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