ArticleSurgical endoscopy2026
Association between the inflow pattern of the left gastric vein and postoperative pancreatic fistula after laparoscopic gastrectomy.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPostoperative pancreatic fistula (POPF) is a significant complication of minimally invasive gastrectomy (MIG). This study investigated whether the preoperatively assessed left gastric vein (LGV) route on contrast-enhanced computed tomography (CT) was associated with POPF.
methodsThis retrospective study included patients who underwent MIG for gastric cancer from January 2017 to December 2020. Based on preoperative CT, LGV anatomy was classified into four types: Type A (dorsal to the common hepatic artery), Type B (ventral to the celiac artery), Type C (dorsal to the splenic artery), and Type D (within the lesser omentum). POPF was defined as a clinically relevant fistula based on drain amylase levels or imaging findings. Risk factors were evaluated using logistic regression analysis.
resultsAmong 566 patients, LGV routes were Type A in 285 (50.3%), Type B in 240 (42.4%), Type C in 28 (4.9%), and Type D in 13 (2.3%). POPF occurred in 14 patients (2.5%). The incidence of POPF differed significantly among LGV types and was highest in Type C (17.9% vs. 1.7% in the other types combined, p < 0.001). All POPF events occurred after laparoscopic gastrectomy, whereas no POPF was observed after robotic gastrectomy. In multivariate analysis, Type C anatomy was the only independent risk factor for POPF.
conclusionsAn LGV course dorsal to the splenic artery (Type C) was associated with an increased risk of POPF after MIG. There is a possibility that robotic gastrectomy may help reduce the risk of POPF in these patients.
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