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Langenbeck's Archives of Surgery

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01-08-2021 | Billroth I Resection | Original Article

Features of the complications for intracorporeal Billroth-I and Roux-en-Y reconstruction after laparoscopic distal gastrectomy for gastric cancer

Authors: Yoshiaki Shoji, Koshi Kumagai, Satoshi Ida, Manabu Ohashi, Naoki Hiki, Takeshi Sano, Souya Nunobe

Published in: Langenbeck's Archives of Surgery | Issue 5/2021

Abstract

Purpose

Recently, the Roux-en-Y procedure (R-Y) and delta-shaped Billroth-I anastomosis (DB-I) have become prevalent as intracorporeal gastroenteric anastomosis methods after laparoscopic distal gastrectomy (LDG) for gastric cancer. However, the differences in postoperative outcomes between the two methods have not been clarified. Hence, this retrospective study aimed to reveal the features of the complications of the R-Y versus DB-I after LDG.

Methods

The study cohort comprised patients with gastric cancer who underwent DB-I or R-Y after LDG from January 2013 to May 2016. Patient characteristics and surgical and postoperative variables were analyzed. To compensate for intergroup differences in baseline characteristics, estimated propensity scores were used to perform one-on-one matching between the groups.

Results

A total of 564 patients were included, and propensity score matching created a matched cohort of 149 pairs in the DB-I and R-Y groups. The incidence of short-term complications such as gastrointestinal fistula classified as Clavien-Dindo grade IIIa or above was significantly greater in the DB-I group than the R-Y group (14.1% versus 4.7%, p=0.004). In contrast, the R-Y was associated with long-term complications such as internal hernia and tended to result in a slightly higher readmission rate in the R-Y group compared with the DB-I group (2.7% versus 6.0%, p=0.128).

Conclusion

DB-I after LDG was associated with a significantly higher rate of short-term complications compared with the R-Y, whereas characteristic long-term complications tended to be observed after the R-Y. These differences should be considered during the selection of the reconstruction method and postoperative management of LDG.

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Title: Features of the complications for intracorporeal Billroth-I and Roux-en-Y reconstruction after laparoscopic distal gastrectomy for gastric cancer
Authors: Yoshiaki Shoji
Koshi Kumagai
Satoshi Ida
Manabu Ohashi
Naoki Hiki
Takeshi Sano
Souya Nunobe
Publication date: 01-08-2021
Publisher: Springer Berlin Heidelberg
Keywords: Billroth I Resection
Gastrectomy
Gastric Cancer
Gastric Cancer
Gastrectomy
Billroth I Resection
Published in: Langenbeck's Archives of Surgery / Issue 5/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-021-02136-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Features of the complications for intracorporeal Billroth-I and Roux-en-Y reconstruction after laparoscopic distal gastrectomy for gastric cancer

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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