Two hemi-purse-string suture for dodenal stump reinforcement during laparoscopic gastrectomy for gastric cancer

We present a novel two hemi-purse-string suture technique for duodenal stump reinforcement in laparoscopic gastrectomy. However, the simplicity and safety of this technique have not yet been fully evaluated. Retrospectively collected data from 217 patients diagnosed with gastric cancer and underwent distal/total gastrectomy at Nanfang Hospital from April 2022 to April 2025, including 107 cases underwent the two hemi-purse-string suture and 110 cases underwent continuous inverting suture. Analyze and compare the clinicopathological information, intraoperative operation time and postoperative complications between two groups of patients. There was no statistically significant difference in baseline data between the two groups (P > 0.05), indicating comparability. Compared to the continuous inverting suture group, patients who underwent duodenal stump reinforcement with the two hemi-purse-string technique demonstrated a significantly shorter duodenal stump suture time (298.2 ± 53.8 s vs. 326.8 ± 78.4 s, t = -3.109, p = 0.002) and required fewer stitches (4.47 ± 0.63 vs. 6.35 ± 1.37, t = -12.892, p < 0.001). Regarding the success of embedding, a successful primary embedding was achieved in 100% (107/107) of cases in the two hemi-purse-string suture group, compared to 99.1% (109/110) in the continuous inverting suture group. No cases in either group experienced duodenal serosal tearing during the reinforcement procedure. The duodenal stump embedding was completed according to the predetermined plan in all patients in both groups (107/107 vs. 110/110). Importantly, no incidents of duodenal stump leakage, pancreatic fistula, or intra-abdominal haemorrhage occurred in either group, indicating comparable safety profiles between the two techniques. The two hemi-purse-string suture used for duodenal stump reinforcement can shorten the suture time and has no postoperative complications such as duodenal stump fistula. It is efficient and reliable.