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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 1/2024

01-12-2024 | Billroth I Resection | Research

Higher incidence of cholelithiasis with Roux-en-Y reconstruction compared with Billroth-I after laparoscopic distal gastrectomy for gastric cancer: a retrospective cohort study

Authors: Taiki Moriyama, Kenoki Ohuchida, Takao Ohtsuka, Koji Shindo, Naoki Ikenaga, Kohei Nakata, Masafumi Nakamura

Published in: Langenbeck's Archives of Surgery | Issue 1/2024

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Abstract

Purpose

Cholelithiasis occurs often after gastrectomy. However, no consensus has been established regarding the difference in the incidence of postgastrectomy cholelithiasis with different reconstruction methods. In this study, we examined the frequency of cholelithiasis after two major reconstruction methods, namely Billroth-I (B-I) and Roux-en-Y (R-Y) following laparoscopic distal gastrectomy (LDG) for gastric cancer.

Methods

Among 696 gastric cancer patients who underwent LDG between April 2000 and March 2017, after applying the exclusion criteria, 284 patients who underwent B-I and 310 who underwent R-Y were examined retrospectively. The estimated incidence of cholelithiasis was compared between the methods, and factors associated with the development of cholelithiasis in the gallbladder and/or common bile duct were investigated.

Results

During the median follow-up of 61.2 months, 52 patients (8.8%) developed cholelithiasis postgastrectomy; 12 patients (4.2%) after B-I and 40 (12.9%) after R-Y (p = 0.0002). Among them, choledocholithiasis was more frequent in patients who underwent R-Y (n = 11, 27.5%) vs. B-I (n = 1, 8.3%) (p = 0.0056). Univariate and multivariate analyses revealed that male sex, body mass index > 22.5 kg/m2, and R-Y reconstruction were significant predictors of the development of postLDG cholelithiasis.

Conclusion

Regarding cholelithiasis development, B-I reconstruction should be preferred whenever possible during distal gastrectomy.
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Metadata
Title
Higher incidence of cholelithiasis with Roux-en-Y reconstruction compared with Billroth-I after laparoscopic distal gastrectomy for gastric cancer: a retrospective cohort study
Authors
Taiki Moriyama
Kenoki Ohuchida
Takao Ohtsuka
Koji Shindo
Naoki Ikenaga
Kohei Nakata
Masafumi Nakamura
Publication date
01-12-2024
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2024
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-024-03267-2

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