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- Title
Long-term outcomes of Roux-en-Y and Billroth-I reconstruction after laparoscopic distal gastrectomy.
- Authors
Inokuchi, Mikito; Kojima, Kazuyuki; Yamada, Hiroyuki; Kato, Keiji; Hayashi, Mikiko; Motoyama, Kazuo; Sugihara, Kenichi
- Abstract
Background: Laparoscopic distal gastrectomy (LDG) is an established procedure for the treatment of early gastric cancer. Roux-en-Y (R-Y) or Billroth-I (B-I) reconstruction is generally performed after LDG in Japan. The aim of this retrospective cohort study was to compare the effectiveness of R-Y and B-I reconstructions and thereby determine which has better clinical outcomes. Methods: We analyzed data from 172 patients with gastric cancer who underwent LDG. Reconstruction was done by R-Y in 83 patients and B-I in 89. All patients were followed up for 5 years. Evaluated variables included symptoms, nutritional status, endoscopic findings, gallstone formation, and later gastrointestinal complications. Results: Scores for the amount of residue in the gastric stump, remnant gastritis, and bile reflux, calculated according to the 'residue, gastritis, bile' scoring system, were significantly lower in the R-Y group (score 0 vs. 1 and more; p = 0.027, <0.001, and <0.001, respectively). The proportion of patients with reflux esophagitis was significantly lower in the R-Y group ( p < 0.001). Relative values (postoperative 5 years/preoperative) for body weight, serum albumin level, and total cholesterol level were similar in the two groups ( p = 0.59, 0.56, and 0.34, respectively). Gallstone formation did not differ between the groups ( p = 0.57). As for later complications, the incidence of gastrointestinal ulcer was 4.5 % in the B-I group, and that of ileus was 3.6 % in the R-Y group, but differences between the groups were not significant ( p = 0.12, 0.11, respectively). Conclusions: As compared with B-I, R-Y was associated with lower long-term incidences of both bile reflux into the gastric remnant and reflux esophagitis.
- Subjects
HEALTH outcome assessment; GASTRECTOMY; LAPAROSCOPIC surgery; COHORT analysis; GALLSTONES; GASTROINTESTINAL diseases
- Publication
Gastric Cancer, 2013, Vol 16, Issue 1, p67
- ISSN
1436-3291
- Publication type
Article
- DOI
10.1007/s10120-012-0154-5