Zhang H, Zhu B, Bai GJ. Predictive value of portal venous phase computed tomography parameters for anastomotic stricture after D2 gastrectomy. World J Gastrointest Surg 2026; 18(6): 118910 [DOI: 10.4240/wjgs.118910]
Corresponding Author of This Article
Gen-Ji Bai, Department of Medical Imaging, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huaiyin District, Huai’an 223300, Jiangsu Province, China. hybgj0451@163.com
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Gastroenterology & Hepatology
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research-article
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Zhang H, Zhu B, Bai GJ. Predictive value of portal venous phase computed tomography parameters for anastomotic stricture after D2 gastrectomy. World J Gastrointest Surg 2026; 18(6): 118910 [DOI: 10.4240/wjgs.118910]
World J Gastrointest Surg. Jun 27, 2026; 18(6): 118910 Published online Jun 27, 2026. doi: 10.4240/wjgs.118910
Predictive value of portal venous phase computed tomography parameters for anastomotic stricture after D2 gastrectomy
Hui Zhang, Bo Zhu, Gen-Ji Bai
Hui Zhang, Bo Zhu, Gen-Ji Bai, Department of Medical Imaging, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, Huai’an 223300, Jiangsu Province, China
Author contributions: Zhang H contributed to formal analysis, methodology, and writing original draft; Zhang H and Zhu B contributed to data curation, investigation; Zhang H and Bai GJ contributed to conceptualization; Zhu B contributed to validation; Zhu B and Bai GJ contributed to writing review and editing; Bai GJ contributed to funding acquisition, project administration, resources, and supervision; all authors have read and approved the final manuscript.
Institutional review board statement: The study protocol was reviewed and approved by the Medical Ethics Committee of Huai’an First People’s Hospital (approval No. YX-Z-2025-063-01).
Informed consent statement: This study was retrospective in nature and involved the use of anonymized clinical and imaging data. The requirement for written informed consent was waived by the Medical Ethics Committee of Huai’an First People’s Hospital.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
Corresponding author: Gen-Ji Bai, Department of Medical Imaging, The Affiliated Huaian No. 1 People’s Hospital of Nanjing Medical University, No. 1 Huanghe West Road, Huaiyin District, Huai’an 223300, Jiangsu Province, China. hybgj0451@163.com
Received: January 13, 2026 Revised: February 8, 2026 Accepted: March 9, 2026 Published online: June 27, 2026 Processing time: 152 Days and 20 Hours
Core Tip
Core Tip: Preoperative quantitative perfusion indicators of portal venous phase computed tomography (CT) relevant to the anastomotic healing. Increased risk of postoperative anastomotic stricture after D2 gastrectomy was significantly associated with decreased normalized portal vein (PV) CT value and reduced PV-to-aorta CT value ratio. Other independent risk factors included body mass index ≥ 25, diabetes, total gastrectomy and use of a 25-mm stapler. Among single markers, the normalized PV-HU value exhibited best predictive performance and a good clinical-imaging combined model showed an area under the curve of 0.893 and high negative predictive value (97.9%). These CT parameters provide preoperative risk stratification with the potential to assist in identifying patients who may benefit from increased surveillance or surgical management alteration. The CT-based tool is simple, non-invasive and tailored to each subject’s perioperative management in gastric cancer surgery.
