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01-02-2021 | Billroth I Resection | Original Article

Functional Outcomes of Delta-Shaped Anastomosis After Laparoscopic Distal Gastrectomy

Authors: Masazumi Sakaguchi, Hisahiro Hosogi, Yukinari Tokoro, Daisuke Yagi, Norihiro Shimoike, Shin Akagawa, Seiichiro Kanaya

Published in: Journal of Gastrointestinal Surgery | Issue 2/2021

Abstract

Background

We invented a simple and secure method of intracorporeal gastroduodenostomy, the delta-shaped anastomosis (DA), using endoscopic linear stapler only and standardized the DA procedure by resecting two-thirds of the stomach based on the anatomical landmarks. This study aimed to evaluate the feasibility of the standardized DA as the standard reconstruction procedure after a laparoscopic distal gastrectomy assessing functional outcomes including postoperative complications, body weight loss, nutritional status, and endoscopic findings.

Methods

The medical records of 349 patients with gastric cancer who underwent laparoscopic distal gastrectomy from April 2011 to December 2017 at our hospital were retrospectively reviewed. Functional outcomes were assessed according to nutritional status and endoscopic findings.

Results

The operation time was shorter and complication rate was lower in the standardized DA than those in Billroth-II (BII) and Roux-en-Y (RY). The body weight loss in DA was 10% 1 year postoperatively and remained stable during the follow-up period, which showed no significant difference. The endoscopic findings showed the ratio of residual food in DA was lower than that in RY (DA:RY = 13.3%:13.6% and 8.4%:33.3% at 1 and 3 years postoperatively, respectively). Severe gastritis was extremely rare in DA (6.7% at 1 year and 15.6% at 3 years postoperatively). Bile reflux was more often found in DA than RY (DA:RY = 19.9%:4.8% and 26.6%:0% at 1 and 3 years postoperatively, respectively). Reflux esophagitis was found 10% of DA only.

Conclusions

Functional outcomes of the standardized DA were satisfactory and feasible. Our intracorporeal Billroth-I reconstruction, by resecting two-thirds of the stomach, can be one of the standard reconstruction methods after a laparoscopic distal gastrectomy.

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Title: Functional Outcomes of Delta-Shaped Anastomosis After Laparoscopic Distal Gastrectomy
Authors: Masazumi Sakaguchi
Hisahiro Hosogi
Yukinari Tokoro
Daisuke Yagi
Norihiro Shimoike
Shin Akagawa
Seiichiro Kanaya
Publication date: 01-02-2021
Publisher: Springer US
Keywords: Billroth I Resection
Esophagitis
Gastrectomy
Gastritis
Gastric Cancer
Billroth II Resection
Gastric Cancer
Billroth II Resection
Gastrectomy
Billroth I Resection
Published in: Journal of Gastrointestinal Surgery / Issue 2/2021
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-020-04516-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Functional Outcomes of Delta-Shaped Anastomosis After Laparoscopic Distal Gastrectomy

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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