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Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review)

  • Authors:
    • Takaya Tokuhara
    • Eiji Nakata
    • Masayuki Higashino
  • View Affiliations / Copyright

    Affiliations: Department of Gastroenterology, Otori Stomach and Intestines Hospital, Sakai, Osaka 593‑8311, Japan, Department of Gastroenterology, Hokusetsu‑Miki Hospital, Suita, Osaka 564‑0002, Japan
    Copyright: © Tokuhara et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 354
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    Published online on: July 4, 2023
       https://doi.org/10.3892/ol.2023.13940
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Abstract

The first part of the duodenum consists of the intraperitoneal segment, called the duodenal bulb, and the retroperitoneal segment. Regarding the blood supplying the duodenal bulb, which is the portion utilized in anastomosing the duodenum and remnant stomach following distal gastrectomy, the arterial pedicles branching off from the gastroduodenal artery are reported to reach the posterior wall first and then spread over the anterior wall, where they anastomose. When performing intracorporeal linear‑stapled gastroduodenostomy following totally laparoscopic distal gastrectomy, the blood supply of the duodenal wall between the transecting staple line and anastomotic staple line needs to be considered because both transection of the duodenal bulb and the gastroduodenostomy are performed using an endoscopic linear stapler and the duodenal wall between the staple lines can be ischemic after the anastomosis. Since it needs to be decided intraoperatively whether this duodenal site is preserved or removed, the present review discusses the technical differences among several procedures for intracorporeal linear‑stapled gastroduodenostomy, classifying them into two groups on the basis of the intraoperative management of this duodenal site. When this site is preserved, the blood supply of the duodenal wall needs to be retained with certainty. On the other hand, when this site is removed, the ischemic portion of the duodenal wall needs to be identified and removed. Furthermore, in both groups, an adequate anastomotic area needs to be secured. In conclusion, surgeons need to be familiar with the anatomical features of the duodenal bulb, including its blood perfusion and shape, when carrying out intracorporeal linear‑stapled gastroduodenostomy.
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Copy and paste a formatted citation
Spandidos Publications style
Tokuhara T, Nakata E and Higashino M: Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review). Oncol Lett 26: 354, 2023.
APA
Tokuhara, T., Nakata, E., & Higashino, M. (2023). Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review). Oncology Letters, 26, 354. https://doi.org/10.3892/ol.2023.13940
MLA
Tokuhara, T., Nakata, E., Higashino, M."Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review)". Oncology Letters 26.2 (2023): 354.
Chicago
Tokuhara, T., Nakata, E., Higashino, M."Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review)". Oncology Letters 26, no. 2 (2023): 354. https://doi.org/10.3892/ol.2023.13940
Copy and paste a formatted citation
x
Spandidos Publications style
Tokuhara T, Nakata E and Higashino M: Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review). Oncol Lett 26: 354, 2023.
APA
Tokuhara, T., Nakata, E., & Higashino, M. (2023). Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review). Oncology Letters, 26, 354. https://doi.org/10.3892/ol.2023.13940
MLA
Tokuhara, T., Nakata, E., Higashino, M."Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review)". Oncology Letters 26.2 (2023): 354.
Chicago
Tokuhara, T., Nakata, E., Higashino, M."Intracorporeal linear‑stapled gastroduodenostomy in totally laparoscopic distal gastrectomy for gastric cancer: Consideration of the intraoperative management of the duodenal wall between the transecting staple line and anastomotic staple line (Review)". Oncology Letters 26, no. 2 (2023): 354. https://doi.org/10.3892/ol.2023.13940
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