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

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Gastric Cancer

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.

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Authors and Affiliations

  1. Department of Visceral, Thoracic and Vascular Surgery, University Hospital Carl Gustav Carus, Technical University Dresden, Fetscherstr. 74, 01307, Dresden, Germany

    Daniel E. Stange MD, PhD & Jürgen Weitz MD, MSc

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  1. Daniel E. Stange MD, PhD
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  2. Jürgen Weitz MD, MSc
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Correspondence to Jürgen Weitz MD, MSc .

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Editors and Affiliations

  1. Gastric and Mixed Tumor Service, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Vivian E. Strong

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Stange, D., Weitz, J. (2015). Methods of Reconstruction—BI, BII, Roux-en-Y, Jejunal Interposition, Proximal Gastrectomy and Pouch Reconstruction. In: Strong, V. (eds) Gastric Cancer. Springer, Cham. https://doi.org/10.1007/978-3-319-15826-6_12

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  • DOI: https://doi.org/10.1007/978-3-319-15826-6_12

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-15826-6

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