用浆肌缝合加固十二指肠残端的意义以及加固吻合器在预防十二指肠残端渗漏方面的有效性仍不清楚。我们的目的是探讨十二指肠残端加固的重要性，并确定预防十二指肠残端渗漏的最佳加固方法。这项回顾性队列研究于2012年1月1日至2021年12月31日进行，分析数据于2022年12月1日至9月30日，2023 年。这项跨日本 57 个机构的多中心研究纳入了 16,475 名接受根治性胃切除术的胃癌患者。对胃癌患者进行择期开腹或微创（腹腔镜或机器人）胃切除术。16,475 名患者中有 153 名（0.93%）发生十二指肠残端漏。十二指肠残端漏患者中男性、年龄≥75岁、≥pN1的比例高于无十二指肠残端漏患者。经浆肌缝合或使用加固吻合器加固组的十二指肠残端渗漏发生率显着低于未加固组（0.72% vs. 1.19%，p = 0.002）。高容量机构的十二指肠残端渗漏发生率也显着低于低容量机构（0.70% vs. 1.65%，p = 0.047）。十二指肠残端漏相关死亡率为7.8%（12/153）。在多变量分析中，术前哮喘和十二指肠侵犯被确定为十二指肠残端渗漏相关死亡率的独立术前危险因素。胃癌患者根治性胃切除术后十二指肠残端应加固，以防止十二指肠残端渗漏。© 2024。作者(s) 获得国际胃癌协会和日本胃癌协会的独家许可。

The significance of reinforcement of the duodenal stump with seromuscular sutures and the effectiveness of reinforced staplers in preventing duodenal stump leakage remain unclear. We aimed to explore the importance of duodenal stump reinforcement and determine the optimal reinforcement method for preventing duodenal stump leakage.This retrospective cohort study was conducted between January 1, 2012 and December 31, 2021, with data analyzed between December 1, 2022 and September 30, 2023. This multicenter study across 57 institutes in Japan included 16,475 patients with gastric cancer who underwent radical gastrectomies. Elective open or minimally invasive (laparoscopic or robotic) gastrectomy was performed in patients with gastric cancer.Duodenal stump leakage occurred in 153 (0.93%) of 16,475 patients. The proportions of males, patients aged ≥ 75 years, and ≥ pN1 were higher in patients with duodenal stump leakage than in those without duodenal stump leakage. The incidence of duodenal stump leakage was significantly lower in the group treated with reinforcement by seromuscular sutures or using reinforced stapler than in the group without reinforcement (0.72% vs. 1.19%, p = 0.002). Duodenal stump leakage incidence was also significantly lower in high-volume institutions than in low-volume institutions (0.70% vs. 1.65%, p = 0.047). The rate of duodenal stump leakage-related mortality was 7.8% (12/153). In the multivariate analysis, preoperative asthma and duodenal invasion were identified as independent preoperative risk factors for duodenal stump leakage-related mortality.The duodenal stump should be reinforced to prevent duodenal stump leakage after radical gastrectomy in patients with gastric cancer.© 2024. The Author(s) under exclusive licence to The International Gastric Cancer Association and The Japanese Gastric Cancer Association.