腹腔鏡補助下幽門下動静脈温存幽門保存胃切除術の有用性

Laparoscopy-assisted pylorus-preserving gastrectomy with infrapyloric vessel preservation

◆要旨：腹腔鏡補助下幽門下動静脈温存幽門保存胃切除術の有用性について検討した．同術式を行った38例（A群）と腹腔鏡補助下幽門下動静脈非温存幽門保存胃切除術24例（B群）の術後成績を比較した．A群38例中33例に幽門下動静脈の温存が可能で，antral cuffはA群で長く，平均3.7cmであった．退院時に1/2以上の食事摂取をしていた患者の割合がA群で63.6％，B群では25.0％であった．術後平均在院日数はA群10.5日，B群14.8日であった．腹腔鏡補助下幽門下動静脈温存幽門保存胃切除術は技術的に施行可能で，術後食事摂取状況が良く，早期の退院が可能であった．

The aim of this study is to investigate efficacy of laparoscopy-assisted pylorus-preserving gastrectomy with infrapyloric vessel preservation. Postoperative outcomes of 38 patients who underwent this operation（Group A） were compared with those of 28 patients who underwent laparoscopy-assisted pylorus-preserving gastrectomy without infrapyloric vessel preservation（Group B）. Infrapyloric artery and vein could be preserved 33 of 38 patients. Mean length of antral cuff of Group A（3.7cm） was longer than that of Group B. A rate of patients who could eat more than half of the meal served at the time of hospital discharge was 63.6％ in Group A and 25.0％ in Group B, respectively. Mean postoperative hospital stays were 10.5 days in Group A and 14.8 days in Group B. Laparoscopy-assisted pylorus-preserving gastrectomy with infrapyloric vessel preservation is technically possible and results in good food intake and short hospital stay.