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Preservation of hepatic branch of the vagus nerve reduces the risk of gallstone formation after gastrectomy.
- Source :
-
Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association [Gastric Cancer] 2021 Jan; Vol. 24 (1), pp. 232-244. Date of Electronic Publication: 2020 Jul 23. - Publication Year :
- 2021
-
Abstract
- Background: Injury to the vagus nerve has been proposed to be associated with occurrence of gallstones after gastrectomy. We investigated the effect of preservation of hepatic branch of the vagus nerve on prevention of gallstones during laparoscopic distal (LDG) and pylorus-preserving gastrectomy (LPPG).<br />Methods: Preservation of the vagus nerve was reviewed of cT1N0M0 gastric cancer patients underwent LDG (n = 323) and LPPG (n = 144) during 2016-2017. Presence of gallstones was evaluated by ultrasonography (US) and computed tomography (CT). Incidences of gallstones were compared between the nerve preserved (h-DG, h-PPG) group and sacrificed (s-DG, s-PPG) group. Clinicopathological features were also compared.<br />Results: The 3-year cumulative incidence of gallstones was lower in the h-DG (2.7%, n = 85) than the s-DG (14.6%, n = 238) (p = 0.017) and lower in the h-PPG (1.6%, n = 123) than the s-PPG (12.9%, n = 21) (p = 0.004). Overall postoperative complication rate was similar between the h-DG and s-DG (p = 0.861) as well as between the h-PPG and s-PPG (p = 0.768). The number of retrieved lymph nodes station #1 and 3-year recurrence-free survival were not significantly different between the preserved group and sacrificed group. Injury to the vagus nerve (p = 0.001) and high body mass index (BMI) (≥ 27.5 kg/m <superscript>2</superscript> ) (p = 0.040) were found to be independent risk factors of gallstone formation in multivariate analysis.<br />Conclusions: Preservation of hepatic branch of the vagus nerve can be recommended for LDG as well as LPPG of early gastric cancer patients to reduce postoperative gallstone formation.
- Subjects :
- Body Mass Index
Female
Gallstones epidemiology
Gallstones etiology
Gastrectomy adverse effects
Humans
Incidence
Laparoscopy adverse effects
Liver innervation
Male
Middle Aged
Organ Sparing Treatments methods
Postoperative Complications epidemiology
Postoperative Complications etiology
Retrospective Studies
Risk Factors
Stomach Neoplasms surgery
Treatment Outcome
Vagus Nerve Injuries etiology
Vagus Nerve Injuries prevention & control
Gallstones prevention & control
Gastrectomy methods
Laparoscopy methods
Postoperative Complications prevention & control
Pylorus surgery
Vagus Nerve surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1436-3305
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
- Publication Type :
- Academic Journal
- Accession number :
- 32705445
- Full Text :
- https://doi.org/10.1007/s10120-020-01106-z