Background/Objective. This study aimed to compare complication rates between pylorus-preserving gastrectomy (PPG) and distal gastrectomy (DG) using Korean nationwide survey data and propensity score weighting (PSW). PPG preserves gastric function but may lead to more postoperative complications than DG. Methods and Results. We analyzed 9424 gastric cancer patients who underwent either DG (n= 9183) or PPG (n= 241). PSW balanced variables such as age, sex, TNM stage, comorbidities, ASA score, and surgical approach. Before PSW, 87.8% of DG patients and 87.1% of PPG patients had no complications (p= 0.053). Severe complications (Clavien–Dindo IIIa or higher) were more frequent in PPG (6.6%) than in DG (3.8%) (p= 0.039). After PSW, overall complication rates (p= 0.960) and severe complication rates (p= 0.574) were similar between groups. Incidence rates of anastomotic stricture and leakage were higher in PPG (2.9% and 1.7%) compared to DG (0.6% and 0.5%) (p= 0.001 and 0.036) before PSW, but these differences were not significant after PSW (p= 0.999 and 0.123). Conclusion. The PSW-adjusted analysis indicates no significant difference in overall and severe complication rates between PPG and DG in gastric cancer patients.
**背景/目的**。本研究旨在利用韩国全国性调查数据和倾向评分加权法，比较保留幽门胃切除术与远端胃切除术的并发症发生率。PPG可保留胃功能，但可能比DG导致更多术后并发症。 **方法与结果**。我们分析了9424例接受DG（n=9183）或PPG（n=241）的胃癌患者。PSW平衡了年龄、性别、TNM分期、合并症、ASA评分和手术方式等变量。PSW前，DG患者中87.8%无并发症，PPG患者中为87.1%（p=0.053）。严重并发症（Clavien-Dindo IIIa级或更高）在PPG组（6.6%）比DG组（3.8%）更常见（p=0.039）。PSW后，两组的总并发症发生率（p=0.960）和严重并发症发生率（p=0.574）相似。PSW前，PPG组的吻合口狭窄和吻合口漏发生率（分别为2.9%和1.7%）高于DG组（0.6%和0.5%）（p=0.001和0.036），但PSW后这些差异无统计学意义（p=0.999和0.123）。 **结论**。经PSW调整后的分析表明，在胃癌患者中，PPG与DG的总并发症发生率和严重并发症发生率均无显著差异。
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