MDCT evaluation of food stasis in remnant stomach after subtotal gastrectomy by laparoscopic versus open abdominal approach

Abstract

Purpose: This study aimed to compare the degree of gastric food stasis and following body fat change after laparoscopic subtotal gastrectomy (LSTG) versus open subtotal gastrectomy (OSTG).Materials and Methods: For 284 consecutive gastric cancer patients who underwent subtotal gastrectomy (213 LSTG and 71 OSTG), the one-year follow-up CT images were reviewed retrospectively. The characteristics of gastric stasis was divided into five degrees (0, no residue; 1, small secretion; 2, poorly-defined amorphous food; 3, well-delineated measurable food; 4, bezoar-like food). The residual food volume was calculated for the patients with the degree 3 or 4 gastric stasis. Postoperative visceral, subcutaneous, and total fat changes were measured on CT and were correlated with the residual food volume.Results: The LSTG group showed higher degrees of gastric stasis (degree 3 [LSTG, 15.0%; OSTG, 9.9%], degree 4 [LSTG, 6.5%; OSTG, 2.8%]) (p=0.072). The mean residual food volume of the LSTG group was larger than that of the OSTG group(13779 versus 6295 cc) (p=0.059). Postoperative abdominal fat change was not significantly different between two groups and was not correlated with the residual food volume.Conclusion: LSTG tends to develop gastric stasis more frequently compared with OSTG, but gastric stasis might hardly affect the postoperative body fat status.