The following is a summary of “Preservation of the celiac branch of the vagus nerve reduces the incidence of postoperative diarrhea in gastric cancer: a cohort study,” published in the April 2024 issue of Surgery by Guo et al.

The study aimed to investigate the short-term and long-term outcomes associated with preserving the celiac branch of the vagus nerve during laparoscopic distal gastrectomy for gastric cancer. A retrospective analysis was conducted on 149 patients diagnosed with gastric cancer who underwent laparoscopic-assisted distal gastrectomy (LADG) with Billroth-II anastomosis and D2 lymph node dissection between 2017 and 2018. Patients were categorized into two groups: the preserved LADG group (P-LADG, n = 56) with preservation of the celiac branch of the vagus nerve, and the resected LADG group (R-LADG, n = 93) where the celiac branch was removed. Propensity score matching was employed to select 56 patients in each group. Postoperative outcomes, including nutritional status, weight changes, short-term and long-term complications, and gallstone formation, were assessed over a 5-year follow-up period. 

Endoscopic evaluations at 12 months postoperatively determined residual gastritis and bile reflux status. The findings revealed a significantly lower incidence of postoperative diarrhea at the 5-year mark in the P-LADG group compared to the R-LADG group (p < 0.05). Multivariate logistic regression analysis identified the vagus nerve celiac branch removal as an independent risk factor for postoperative diarrhea occurrence (odds ratio = 3.389, 95% confidence interval = 1.143-10.049, p = 0.028). Consequently, preserving the celiac branch of the vagus nerve during LADG demonstrated a notable reduction in postoperative diarrhea incidence, presenting a valuable consideration in the surgical management of gastric cancer.

Source: wjso.biomedcentral.com/articles/10.1186/s12957-024-03370-0