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Pylorus-preserving procedure in partial and total gastrectomy.

T Maki, T Sato, T Shiratori

    Langenbecks Archiv Fur Chirurgie
    |February 12, 1977
    PubMed
    Summary

    Pylorus-preserving gastrectomy (PPG) and the Maki procedure offer effective surgical options for gastric conditions. These techniques preserve pyloric function, reducing dumping syndrome and reflux esophagitis for improved patient outcomes.

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    Area of Science:

    • Gastroenterology
    • Surgical Oncology
    • Digestive Surgery

    Background:

    • Gastric surgeries often involve pylorus removal, leading to complications like dumping syndrome and reflux esophagitis.
    • Pylorus-preserving gastrectomy (PPG) and the Maki procedure are alternative techniques aiming to mitigate these adverse effects.

    Purpose of the Study:

    • To report the operative techniques and postoperative outcomes of the original pylorus-preserving gastrectomy (PPG) and the Maki procedure.
    • To evaluate the efficacy of these methods in preserving pyloric function and preventing common post-gastrectomy complications.

    Main Methods:

    • Description of the operative technique for PPG, emphasizing the retention of a 1.0-1.5 cm pyloric cuff.
    • Description of the Maki procedure involving jejunal interposition after nearly-total proximal gastrectomy.
    • Assessment of postoperative results, focusing on food passage, dumping syndrome, and reflux esophagitis.

    Main Results:

    • PPG and the Maki procedure facilitate gradual, rhythmic food emptying into the duodenum, successfully avoiding dumping syndrome and reflux esophagitis.
    • PPG demonstrates effectiveness in treating intractable gastric ulcers and benign distal gastric lesions.
    • The Maki procedure is recommended for patients with tumors free from the pylorus and surrounding areas.

    Conclusions:

    • Pylorus-preserving gastrectomy (PPG) is a recommended surgical approach for specific benign gastric conditions, particularly distal lesions.
    • The Maki procedure is a viable option for selected proximal gastrectomy cases where the pylorus is tumor-free.
    • Both techniques highlight the importance of preserving pyloric function to enhance postoperative quality of life.

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