[A report on pancreas-preserving operation and complications relating pancreatorrhea in total gastrectomy]

During the period from 1986 to 1993, a total gastrectomy was performed in 174 patients with gastric malignancy in Uwajima City Hospital. Among these patients, 160 patients required lymph node dissection around the splenic artery, 109 (68.1%) of whom received pancreas-preserving operation and 51 distal pancreatectomy. Although in the former group only 3 patients (2.8%) had complications relating to pancreatorrhea, 14 patients (27.5%) suffered this complication in the latter group. On the other hand, only about 11.5% were histologically proved to have metastatic involvement in the lymph nodes around the splenic artery. These findings suggest that pancreas-preserving operation should be positively evaluated in lymph node dissection around the splenic artery.