Pancreatic atrophy after gastrectomy for gastric cancer

Surg Today. 2021 Mar;51(3):432-438. doi: 10.1007/s00595-020-02131-2. Epub 2020 Sep 3.

Abstract

Purpose: To investigate the phenomenon of pancreatic atrophy after gastrectomy for gastric cancer, using computed tomography (CT) volumetry.

Methods: The subjects of this retrospective study were 77 patients who underwent distal gastrectomy (DG) or total gastrectomy (TG) for pStage I gastric cancer in 2014. The relative pancreatic volume ratio was assessed preoperatively, and then 1 and 5 years postoperatively and the results were compared between surgical procedures RESULTS: A total of 14 patients underwent TG with Roux-en-Y (RY) reconstruction, 24 underwent DG with Billroth-I (BI) reconstruction, and 39 underwent DG with RY reconstruction. We observed that the pancreatic volume continued to decrease over the 5 years after DG or TG. Furthermore, the incidence of pancreatic atrophy 5 years postoperatively was significantly greater after TG than after DG. In patients who underwent DG, a greater incidence of pancreatic atrophy was observed after RY reconstruction than after BI reconstruction, 5 years postoperatively.

Conclusion: The pancreatic volume continued to decrease after DG and TG for gastric cancer 5 years after treatment. TG was associated with a significantly greater incidence of pancreatic atrophy than DG 5 years postoperatively, as was RY reconstruction vs. BI reconstruction after DG.

Keywords: Gastrectomy; Pancreatic atrophy; Pancreatic volumetry.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y
  • Atrophy / diagnostic imaging
  • Atrophy / etiology
  • Cone-Beam Computed Tomography
  • Digestive System Surgical Procedures / methods
  • Female
  • Follow-Up Studies
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Pancreas / diagnostic imaging*
  • Pancreas / pathology*
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Time Factors