Ye YX, Wu CY, Chen LQ, Wu SJ, Ye K. Controversies and consensus surrounding laparoscopic pylorus-preserving gastrectomy for early gastric cancer. World J Gastrointest Surg 2025; 17(5): 105295 [DOI: 10.4240/wjgs.v17.i5.105295]
Corresponding Author of This Article
Kai Ye, MD, PhD, Associate Professor, Chief Physician, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Quanzhou 362000, Fujian Province, China. medwcy@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. May 27, 2025; 17(5): 105295 Published online May 27, 2025. doi: 10.4240/wjgs.v17.i5.105295
Controversies and consensus surrounding laparoscopic pylorus-preserving gastrectomy for early gastric cancer
Ying-Xuan Ye, Chu-Ying Wu, Li-Quan Chen, Si-Jia Wu, Kai Ye
Ying-Xuan Ye, School of Medicine, South China University of Technology, Guangzhou 510000, Guangdong Province, China
Chu-Ying Wu, Li-Quan Chen, Kai Ye, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Si-Jia Wu, Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Fujian Medical University, Quanzhou 362000, Fujian Province, China
Co-first authors: Ying-Xuan Ye and Chu-Ying Wu.
Author contributions: Ye YX and Wu CY contributed equally to the study, contributed to original draft preparation, writing, and review; Chen LQ contributed to writing, review, and editing; Wu SJ contributed to writing, review; Ye K contributed to conceptualization, supervision, and funding acquisition; all authors have read and agreed to the published version of the manuscript.
Supported by Quanzhou Science and Technology Plan Projects, No. 2024NY033; Fujian Provincial Health and Youth Research Project, No. 2022QH1117; and Key Clinical Specialty Discipline Construction Program of Fujian (Fujian Health Medicine and Politics), No. [2022]884.
Conflict-of-interest statement: All authors report no conflicts of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Ye, MD, PhD, Associate Professor, Chief Physician, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Fujian Medical University, No. 950 Donghai Street, Quanzhou 362000, Fujian Province, China. medwcy@163.com
Received: January 18, 2025 Revised: February 28, 2025 Accepted: March 10, 2025 Published online: May 27, 2025 Processing time: 125 Days and 23.4 Hours
Abstract
In recent years, the detection rate of early gastric cancer in China has significantly increased. Early gastric cancer is associated with a favourable prognosis; thus, enhancing the postoperative quality of life for patients has become an increasingly pressing issue in treating gastric cancer. Consequently, function-preserving gastrectomy has emerged as a viable option. This surgical approach aims to minimize the extent of resection while preserving some gastric function, all within the framework of radical tumour excision. Pylorus-preserving gastrectomy (PPG) serves as a representative example of a function-preserving technique and is particularly suitable for early-stage gastric cancer of the middle segment of the stomach. Compared with distal gastrectomy, laparoscopic PPG offers several advantages: (1) Results in less surgical trauma; and (2) Reduces the incidence of postoperative complications such as dumping syndrome, bile reflux gastritis, and gallstones while also improving nutritional status postsurgery. However, the implementation of PPG remains contentious within the medical community. In light of new Japanese guidelines for gastric cancer treatment and informed by current research trends along with relevant evidence-based medicine principles, this review examines various aspects related to laparoscopic PPG, including its definition and indications, safety profile, benefits, technical considerations, methods for digestive tract reconstruction and postoperative complications.
Core Tip: Pylorus-preserving gastrectomy (PPG) is indicated for early-stage gastric cancer located in the middle part of the stomach. This article reviewed the definition and indications, safety profile, benefits, technical considerations, methods for digestive tract reconstruction and postoperative complications associated with laparoscopic PPG on the basis of the latest relevant guidelines and research findings.
