Related Experiment Video
Updated: Jan 7, 2026
Author Spotlight: Point-of-Care Ultrasound for Gastric Content Assessment and Risk Stratification in Perioperative Care
Published on: September 22, 2023
Gastric Distension Index: A Novel Radiographic Marker Associated With Postoperative Gastric Stasis After Gastrectomy
Hiroki Harada1, Yoshiko Yamaoka1, Akiko Watanabe2
1Department of Upper Gastrointestinal Surgery Kitasato University School of Medicine Sagamihara Kanagawa Japan.
Background:
Gastric remnant distension after gastrectomy is associated with gastrointestinal symptoms and poor postoperative outcomes, particularly in elderly patients. However, no objective clinical index has been established to define or predict this condition.
Methods:
We retrospectively analyzed 67 patients who underwent distal gastrectomy (DG) in 2019 with upright abdominal X-ray imaging. Radiographic indices were evaluated for their association with gastrointestinal symptoms and the need for intervention for postoperative gastric stasis. The maximum width of the gastric bubble was the most predictive and standardized into the Hiki Index (HI). A cutoff value was determined from ROC analysis based on stasis-related intervention. Validation was performed in a prospectively collected cohort of 136 patients who underwent DG or pylorus-preserving gastrectomy (PPG) between 2022 and 2023 after clinical implementation of the HI.
Results:
In the test set, HI showed high predictive accuracy for stasis-related intervention (AUC 0.78, sensitivity 85.7%, specificity 76.7%). In the validation set, HI predicted symptoms such as nausea (AUC 0.77), bloating (0.77), and belching (0.90). HI-based gastric distension was not associated with postoperative complications. Age < 75 years (OR 3.29), female sex (OR 2.58), and undergoing PPG (OR 6.21) were identified as independent risk factors for gastric distension.
Conclusion:
The HI is a reproducible and practical radiographic indicator for identifying patients at risk of postoperative gastric stasis and related symptoms. Its use may facilitate early intervention and improve postoperative care. Prospective implementation of the HI contributed to more consistent symptom documentation and clearer associations between HI and gastrointestinal symptoms.
More Related Videos
04:05Endoscopic Vacuum Therapy for the Treatment of Anastomotic Leakage after Total Gastrectomy with Esophagojejunostomy
Published on: August 22, 2025
03:32Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
Related Concept Videos
01:26Imaging Studies III: Gastrointestinal Motility Studies and Virtual Colonoscopy
Radionuclide Testing
Radionuclide testing is a sophisticated medical technique for assessing gastrointestinal motility. It focuses on gastric emptying and colonic transit time. Radioactive markers track the movement of food through the digestive system, providing insights into gastrointestinal disorders.
In gastric emptying studies, a meal's liquid and...
01:28Peptic Ulcer Disease III: Clinical Manifestations and Diagnostic Studies
Few clinical manifestations differentiate gastric ulcers from duodenal ulcers. Distinctions in the location, timing, and pain relief are crucial for healthcare providers in differentiating between gastric and duodenal ulcers during clinical assessments.
01:16Gastric Emptying
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:23Gastritis III: Clinical Manifestations and Management
Clinical manifestations of acute gastritis
The patient with acute gastritis may have a rapid onset of symptoms, such as epigastric pain or discomfort, dyspepsia, anorexia, hiccups, or nausea and vomiting, which can last from a few hours to a few days. Erosive or hemorrhagic gastritis may cause bleeding, which may manifest as blood in vomit or as...