Yonsei Med J.  2014 Jan;55(1):162-169. 10.3349/ymj.2014.55.1.162.

Totally Laparoscopic Roux-en-Y Gastrojejunostomy after Laparoscopic Distal Gastrectomy: Analysis of Initial 50 Consecutive Cases of Single Surgeon in Comparison with Totally Laparoscopic Billroth I Reconstruction

• An JY
• Cho I
• Choi YY
• Kim YM
• Noh SH

• KMID: 1779901
• DOI: http://doi.org/10.3349/ymj.2014.55.1.162

Abstract

PURPOSE
Roux-en-Y reconstruction (RY) in laparoscopic distal gastrectomy for gastric cancer is a more complicated procedure than Billroth-I (BI) or Billroth-II. Here, we offer a totally laparoscopic simple RY using linear staplers.
MATERIALS AND METHODS
Each 50 consecutive patients with totally laparoscopic distal gastrectomy with RY and BI were enrolled in this study. Technical safety and surgical outcomes of RY were evaluated in comparison with BI.
RESULTS
In all patients, RY gastrectomy using linear staplers was safely performed without any events during surgery. The mean operation time and anastomosis time were 177.0+/-37.6 min and 14.4+/-5.6 min for RY, respectively, which were significantly longer than those for BI (150.4+/-34.0 min and 5.9+/-2.2 min, respectively). There were no differences in amount of blood loss, time to flatus passage, diet start, length of hospital stay, and postoperative inflammatory response between the two groups. Although there was no significant difference in surgical complications between RY and BI (6.0% and 14.0%), the RY group showed no anastomosis site-related complications.
CONCLUSION
The double stapling method using linear staplers in totally laparoscopic RY reconstruction is a simple and safe procedure.

Keyword

Intracorporeal Roux-en-Y gastrojejunostomy; totally laparoscopic distal gastrectomy; intracorporeal Billroth-I reconstruction; technical safety; surgical outcome

MeSH Terms

Aged
Female
Gastrectomy/*methods
Gastric Bypass/*methods
Humans
Laparoscopy/*methods
Male
Middle Aged
Stomach Neoplasms/surgery