Retrospective Cohort Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2025; 17(6): 104333
Published online Jun 27, 2025. doi: 10.4240/wjgs.v17.i6.104333
Predictive model and prognostic insights into duodenal stump fistula following radical gastrectomy with Roux-en-Y reconstruction for gastric cancer
Yang Yu, Suguru Yamauchi, Sanae Kaji, Yukinori Yube, Motomi Nasu, Yutaro Yoshimoto, Ming Cheng, Asako Ozaki, Takehiro Watanabe, Hajime Orita, Kaitlyn Ecoff, Shuko Nojiri, Shinji Mine, Yong-You Wu, Tetsu Fukunaga
Yang Yu, Suguru Yamauchi, Sanae Kaji, Yukinori Yube, Motomi Nasu, Yutaro Yoshimoto, Ming Cheng, Asako Ozaki, Takehiro Watanabe, Hajime Orita, Shinji Mine, Yong-You Wu, Tetsu Fukunaga, Department of Esophageal and Gastroenterological Surgery, Juntendo University, Tokyo 113-8431, Japan
Yang Yu, Gastrointestinal Cancer Center, Peking University Cancer Hospital and Institute, Beijing 100142, China
Suguru Yamauchi, Kaitlyn Ecoff, Department of Surgery, Johns Hopkins University, Baltimore, MD 21287, United States
Ming Cheng, Yong-You Wu, Department of Gastrointestinal Surgery, The Second Affiliated Hospital of Soochow University, Suzhou 215004, Jiangsu Province, China
Shuko Nojiri, Medical Technology Innovation Center, Juntendo University, Tokyo 113-8421, Japan
Co-corresponding authors: Suguru Yamauchi and Tetsu Fukunaga.
Author contributions: Fukunaga T designed the research; Kaji S, Yube Y, and Yu Y collected the clinical data; Yu Y analyzed the data; Yu Y and Yamauchi S wrote the paper; Yamauchi S, Kaji S, Yube Y, Nasu M, Yoshimoto Y, Cheng M, Ozaki A, Watanabe T, Orita H, Ecoff K, Nojiri S, Mine S, and Wu YY participated in the review and editing; Nojiri S confirmed the appropriateness of the statistics; Fukunaga T corrected and approved the manuscript; Yamauchi S and Fukunaga T contributed equally as co–corresponding authors, jointly guiding the interpretation of results and overall study direction; Fukunaga T is the designated contact for all journal correspondence.
Supported by the China Scholarship Council Fund, No. 202308050094.
Institutional review board statement: This study was approved by the Institutional Ethics Committee of Juntendo University Hospital (No. H20-0396).
Informed consent statement: The need for informed consent was waived given the retrospective and observational nature of the study. An opt-out approach was used by accessing a written disclosure on the study’s website (URL: https://www.gcprec.juntendo.ac.jp/kenkyu/detail/3222).
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tetsu Fukunaga, MD, PhD, Chief Physician, Professor, Department of Esophageal and Gastroenterological Surgery, Juntendo University, 2-1-1 Hongo Bunkyo Ward, Tokyo 113-8431, Japan. t2fukunaga@gmail.com
Received: December 18, 2024
Revised: March 24, 2025
Accepted: April 29, 2025
Published online: June 27, 2025
Processing time: 164 Days and 1.6 Hours
Core Tip

Core Tip: This retrospective cohort study included 325 patients who underwent radical gastrectomy with Roux-en-Y reconstruction to identify risk factors for duodenal stump fistula (DSF). Age and obstructive ventilatory failure were identified as independent risk factors for DSF. A nomogram incorporating these risk factors demonstrated robust predictive performance for DSF. DSF significantly affected cancer-specific survival. Suturing fixation of the duodenal stump to the jejunal wall has shown potential as an effective strategy for preventing DSF.