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Different features of complications with Billroth-I and Roux-en-Y reconstruction after laparoscopy-assisted distal gastrectomy.

AbstractBACKGROUND:
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.
AuthorsKoshi Kumagai, Naoki Hiki, Souya Nunobe, Xiaohua Jiang, Takeshi Kubota, Susumu Aikou, Ryohei Watanabe, Shinya Tanimura, Takeshi Sano, Yuko Kitagawa, Toshiharu Yamaguchi
JournalJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract (J Gastrointest Surg) Vol. 15 Issue 12 Pg. 2145-52 (Dec 2011) ISSN: 1873-4626 [Electronic] United States
PMID21948148 (Publication Type: Evaluation Study, Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Anastomosis, Roux-en-Y (adverse effects)
  • Female
  • Gastrectomy
  • Gastroenterostomy (adverse effects)
  • Humans
  • Incidence
  • Japan
  • Laparoscopy
  • Male
  • Middle Aged
  • Postoperative Complications (etiology)
  • Plastic Surgery Procedures (adverse effects)
  • Stomach Neoplasms (pathology, surgery)

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