ArticleSurgical endoscopy2026
Pylorus-preserving gastrectomy enhances long-term bone health in older adults after 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
purposeGastrectomy for gastric cancer (GC) can impair gastrointestinal function, leading to malabsorption, bone loss, and vertebral fractures (VFs), especially in older adults. Pylorus-preserving gastrectomy (PPG) may attenuate these metabolic complications. This study compared long-term bone outcomes after laparoscopic distal gastrectomy with Billroth-I reconstruction (LDGBI) versus laparoscopic PPG (LPPG).
methodsWe retrospectively analyzed 75 patients aged ≥75 years with clinical T1N0M0 GC who underwent LDGBI (n = 50) or LPPG (n = 25) between 2005 and 2019. Bone mineral density (BMD) was measured using CT-based Hounsfield units at L1, and VFs were evaluated 1, 3, and 5 years postoperatively. Analysis of covariance and logistic regression were performed.
resultsBMD loss was significantly greater after LDGBI at 3 years (10 vs. 5 HU, P = 0.038) and 5 years (16 vs. 6 HU, P = 0.036). VF incidence was higher in the LDGBI group at 3 years (14.0% vs. 0%, P = 0.014) and 5 years (28.0% vs. 8.0%, P = 0.034). LDGBI was independently associated with greater 5-year BMD reduction (coefficient 7.83, 95% CI 0.22-15.44, P = 0.044). Logistic regression showed no significant association with VFs (OR 3.57, 95% CI 0.71-17.88, P = 0.12).
conclusionLPPG was associated with reduced long-term BMD loss in older GC patients and may better preserve postoperative bone health.
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