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Delta-shaped anastomosis, a good substitute for conventional Billroth I technique with comparable long-term functional outcome in totally laparoscopic distal gastrectomy

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Abstract

Background

Delta-shaped anastomosis (DA) is a new Billroth I reconstruction technique using only a laparoscopic linear stapler under a totally laparoscopic approach. The present study compared the outcomes of DA with those of laparoscopic conventional Billroth I anastomosis (cBIA).

Methods

A total of 138 and 100 patients with gastric cancer who underwent laparoscopic distal gastrectomy with DA and cBIA, respectively, were selected. Clinicopathological data and short- and long-term outcomes were compared between the two groups.

Results

The mean operating time in the DA group was similar to that in the cBIA group. Short-term outcomes, such as bowel function recovery, morbidity, and mortality, did not differ between the DA and cBIA groups. There were no significant differences in the 5-year disease-free and overall survival rates between the two groups. All nutritional indices (body weight change, albumin level, transferrin level, and total lymphocyte count) were similar between the two groups with the exception of a few points in the early follow-up period. Endoscopic evaluation using the Residual food, Gastritis, Bile reflux classification revealed relatively better gastritis findings in the DA group despite worse bile reflux for 5 postoperative years. The food amount was significantly larger in the DA group for 2 postoperative years.

Conclusions

The outcomes of DA were comparable to those of cBIA. DA is a recommendable reconstruction method, especially in totally laparoscopic distal gastrectomy.

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Acknowledgments

This study was supported by a Grant from the National Research Foundation of Korea (No. 2012R1A1A1043576).

Disclosures

Drs. Han Hong Lee, Kyo Young Song, Jeong Sun Lee, Seung-Man Park, and Jin-Jo Kim have no conflicts of interest or financial ties to disclose.

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Authors and Affiliations

  1. Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea

    Han Hong Lee, Kyo Young Song, Jeong Sun Lee, Seung-Man Park & Jin-Jo Kim

  2. Department of Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 665-8 Bupyeong 6-dong, Bupyeong-gu, Incheon, 403-720, Korea

    Jin-Jo Kim

Authors
  1. Han Hong Lee
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  2. Kyo Young Song
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  3. Jeong Sun Lee
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  4. Seung-Man Park
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Correspondence to Jin-Jo Kim.

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Lee, H.H., Song, K.Y., Lee, J.S. et al. Delta-shaped anastomosis, a good substitute for conventional Billroth I technique with comparable long-term functional outcome in totally laparoscopic distal gastrectomy. Surg Endosc 29, 2545–2552 (2015). https://doi.org/10.1007/s00464-014-3966-z

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  • DOI: https://doi.org/10.1007/s00464-014-3966-z

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