Totally laparoscopic pylorus-preserving gastrectomy is safe for early gastric cancer.

• Patients undergoing pylorus-preserving surgery had shorter operative times (226 vs. 272 minutes) and shorter hospital stays (9.2 vs. 10.5 days).
• Higher risk of delayed gastric emptying was noted (12.5% vs. 1.6%).
• Patients in the pylorus-preserving group showed improved nutritional status and quality of life.

Consider pylorus-preserving approaches for selected early-stage cases to enhance postoperative outcomes, but monitor for complications.