A Risk Analysis for Ischemic Necrosis of the Remnant Stomach After Distal Pancreatectomy in Patients With Previous Distal Gastrectomy: A Multicenter Retrospective Survey by the Japanese Society of Pancreatic Surgery

IF 2.8 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2025-07-04 DOI:10.1002/jhbp.12182

Takashi Kishi, Yoshitsugu Tajima, Hikota Hayashi, Yasunari Kawabata, Kenichiro Uemura, Minako Nagai, Kohei Nishio, Kengo Fukuzawa, Shintaro Yagi, Masaaki Hidaka

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引用次数: 0

Abstract

Background/Purpose

The remnant stomach after distal gastrectomy (DG) which receives its blood supply mainly from the splenic artery (SPA), is at high risk for gastric ischemia following distal pancreatectomy (DP). We investigated the risk factors for ischemic necrosis of the remnant stomach (INS) during or after DP in DG patients.

Patients/Methods

We collected 414 patients who underwent DP after DG between July 2009 and December 2019 by distributing questionnaires to members of the Japanese Society of Pancreatic Surgery (JSPS) in 2020, and the risk factors for INS were analyzed in 364 eligible patients.

Results

INS developed in 17 (4.7%) patients. A multivariate logistic regression analysis revealed that dissection of the left inferior phrenic artery (LIPA) during DP (odds ratio [OR] 51.9, p < 0.001), current DP for pancreatic cancer (OR 6.19, p = 0.017), and previous DG for gastric cancer (OR 6.12, p = 0.017) were independent risk factors for INS.

Conclusions

Preservation of the LIPA is necessary to avoid INS when DP is performed in DG patients. Additionally, careful surgical management is required in patients undergoing DP for pancreatic cancer and who have undergone DG for gastric cancer because they are candidates for INS after DP.

Abstract Image

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日本胰腺外科学会的一项多中心回顾性调查：既往远端胃切除术患者在远端胰腺切除术后残胃缺血性坏死的风险分析。

背景/目的：远端胃切除术（DG）后的残胃，其血液供应主要来自脾动脉（SPA），是远端胰腺切除术（DP）后胃缺血的高危部位。我们研究了DG患者DP期间或之后残胃缺血性坏死（INS）的危险因素。患者/方法：我们通过向2020年日本胰腺外科学会（JSPS）的成员分发问卷，收集了2009年7月至2019年12月期间在DG后接受DP的414例患者，并对364例符合条件的患者进行INS的危险因素分析。结果：17例（4.7%）患者发生INS。一项多因素logistic回归分析显示，在DP过程中，左膈下动脉（LIPA）被剥离（优势比[OR] 51.9, p）。结论：在DG患者进行DP时，保留LIPA是必要的，以避免INS。此外，胰腺癌行DP和胃癌行DG的患者需要谨慎的手术管理，因为他们是DP后INS的候选者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.