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Concept: Gastrectomy


In recent years, laparoscopy-assisted distal gastrectomy has become the recognized procedure for treatment of early gastric cancer because of improved cosmesis and reduced postoperative pain. However, there are a few reports of laparoscopic-assisted total gastrectomy (LATG) performed for gastric cancer in the upper third or middle third stomach due to the difficulties of surgical techniques and the safety of oncologic short-term and long-term outcomes.

Concepts: Metastasis, Stomach, Helicobacter pylori, Term, Abdomen, Stomach cancer, Gastrectomy


An optimal method for intracorporeal esophagojejunostomy has not yet been standardized. This study sought to introduce intracorporeal hand-sewn end-to-side esophagojejunostomy after totally laparoscopic total gastrectomy.

Concepts: Object-oriented programming, Method, Gastrectomy


Although internal hernia (IH) has been reported after laparoscopic distal or total gastrectomy with Roux-en-Y reconstruction, there are few reports of IH after proximal gastrectomy with jejunal interposition (PG-JI). The aim of this study was to analyze the incidence and clinical features of IH after PG-JI. This study retrospectively reviewed 71 patients who underwent PG-JI for gastric cancer at a single institution between July 2007 and December 2016. The median follow-up period after PG-JI was 50 months. Four patients (5.6%) developed IH. IH occurred in 3 of 38 patients after open PG (7.9%) and 1 of 33 after laparoscopic PG (3.1%; p = 0.38). The site of IH was Petersen in all cases, where the Petersen defect was not closed. All patients had abdominal pain at onset, and the CT revealed a whirl sign. Bowel resection was required in three patients (75%). There was no morbidity. IH after PG-JI occurred regardless of operative approach (open or laparoscopic). A high degree of suspicion for IH should be maintained in patients after gastrectomy with abdominal pain and a whirl sign on CT. Closure of the mesenteric defects should be considered to reduce the incidence of IH after surgery.

Concepts: Surgery, Stomach, Small intestine, Bowel obstruction, Abdomen, Duodenum, Closed set, Gastrectomy


Total gastrectomy (TG) is responsible for symptoms or disturbance of alimentary status (changes in body weight, food intake per meal and frequency of meal per day) which, in turn are responsible for weight loss and malnutrition. The study evaluates the gut hormone responses in totally gastrectomized (TG) patients after a liquid meal test.

Concepts: Nutrition, Obesity, Mass, Food, Gastrectomy


Total gastrectomy (TG) and proximal gastrectomy (PG) are used to treat upper-third early gastric cancer. To date, no consensus has been reached regarding which procedure should be selected. The aim of this study was to validate the usefulness of preserving the stomach in early upper-third gastric cancer.

Concepts: Metastasis, Stomach, Helicobacter pylori, Abdomen, Stomach cancer, Gastrectomy


Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction.

Concepts: Epidemiology, Clinical trial, Randomized controlled trial, Stomach, Digestion, Duodenum, Stomach cancer, Gastrectomy


The aim of this study was to clarify internal hernia (IH) characteristics after laparoscopic gastrectomy.

Concepts: Surgery, Stomach, Hernia, Gastrectomy


Esophagojejunal anastomotic leakage (EJAL) is considered to be one of the most serious complications after total gastrectomy (TG), despite improvements in surgical instruments and technique. The occurrence of EJAL would cause poorer quality of life, prolonged hospital stay, and increased surgery-related costs and mortality. Although there is ever-increasing knowledge about EJAL, the optimal management is controversial. In the present review, we aim to demonstrate the effective management by focus on the possible risk factors, potentially useful preventive strategies, and several kinds of treatments in esophagojejunal anastomotic leakage after total gastrectomy for gastric cancer.

Concepts: Present, Epidemiology, Surgery, Stomach, Management, Operations research, Surgical instrument, Gastrectomy


The postoperative health-related quality of life (HRQOL) outcomes in patients with gastroesophageal junction (GEJ) adenocarcinoma after gastrectomy and esophagectomy are unclear. The aim was to evaluate HRQOL outcomes 6 months after extended total gastrectomy, subtotal esophagectomy, and combined esophagogastrectomy.

Concepts: Life, Quality, Quality of life, Gastrectomy


An 80-year-old male with obstructive jaundice and prior conventional Billroth II gastrectomy was referred for ERCP. The procedure was performed with side-viewing duodenoscope (Olympus TjF-145) and standard sphincterotome. The afferent limb was intubated and papilla approached from below which located both the direction of cannulation and duodenal stump to appear toward 6 o'clock position. This article is protected by copyright. All rights reserved.

Concepts: Digestive system, Liver, Hepatology, Gastrectomy