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Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy

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Journal of Gastrointestinal Surgery

Abstract

Background

This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer.

Material and methods

The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien–Dindo classification, and risk factors related to postoperative complications were analyzed.

Results

B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15.2 ± 10.5 days) than in B-I (12.8 ± 6.4 days; P = 0.034). The incidence of severe complications was higher in R-Y (13.7%) than in B-I (5.2%; P = 0.009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0.006).

Conclusions

The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan

    Koshi Kumagai, Naoki Hiki, Souya Nunobe, Xiaohua Jiang, Takeshi Kubota, Susumu Aikou, Ryohei Watanabe, Shinya Tanimura, Takeshi Sano & Toshiharu Yamaguchi

  2. Department of General Surgery, Zhongda Hospital, Southeast University, Nanjing, China

    Xiaohua Jiang

  3. Department of Surgery, School of Medicine, Keio University, Tokyo, Japan

    Yuko Kitagawa

Authors
  1. Koshi Kumagai
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  2. Naoki Hiki
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  3. Souya Nunobe
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  4. Xiaohua Jiang
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  5. Takeshi Kubota
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  6. Susumu Aikou
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  7. Ryohei Watanabe
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  8. Shinya Tanimura
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  9. Takeshi Sano
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  10. Yuko Kitagawa
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  11. Toshiharu Yamaguchi
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Corresponding author

Correspondence to Naoki Hiki.

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Kumagai, K., Hiki, N., Nunobe, S. et al. Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy. J Gastrointest Surg 15, 2145–2152 (2011). https://doi.org/10.1007/s11605-011-1683-7

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  • DOI: https://doi.org/10.1007/s11605-011-1683-7

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