Gastric Cancer pp 175-183 | Cite as

Methods of Reconstruction—BI, BII, Roux-en-Y, Jejunal Interposition, Proximal Gastrectomy and Pouch Reconstruction

Chapter
First Online:

Abstract

In this chapter, reconstruction techniques after partial (proximal or distal) and total gastrectomy are discussed. Proximal gastrectomy is most frequently reconstructed with a jejunal interposition. Distal gastrectomy is mainly reconstructed by a Billroth I or II, or a Roux-en-Y operation. Total gastrectomy is reconstructed by a Roux-en-Y or a jejunal or colonic interposition. The formation of a pouch after total gastrectomy is an often performed additional procedure during reconstruction. No evidence-based recommendation which favors reconstruction over proximal resection can be made till date. After distal resection, randomized controlled trials favor a Roux-en-Y reconstruction due to the lower incidence of bilio-pancreatic reflux. After total gastrectomy, randomized controlled trials demonstrated no difference between duodenal-passage-preserving and direct Roux-en-Y reconstructions while better results were achieved in reconstructions including a pouch.

Keywords

Gastric cancer Surgery Gastrectomy Reconstruction Billroth Roux-en-Y Interposition Pouch 
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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  1. 1.Department of Visceral, Thoracic and Vascular SurgeryUniversity Hospital Carl Gustav Carus, Technical University DresdenDresdenGermany

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