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Comparison of Billroth I and Billroth II reconstructions after laparoscopy-assisted distal gastrectomy: a retrospective analysis of large-scale multicenter results from Korea

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Affiliated Author(s)
류승완
Alternative Author(s)
Ryu, Seung Wan
Journal Title
Surgical Endoscopy
ISSN
0930-2794
Issued Date
2011
Keyword
Laparoscopic gastrectomyGastric cancerBillroth I reconstructionBillroth II reconstructionComplications
Abstract
Background Since reconstruction after laparoscopyassisted
distal gastrectomy (LADG) is performed through
a small minilaparotomy window, the clinical course and
complication rate are influenced by clinical technical
expertise and experience. The aim of this study was
to compare postoperative complications and survival
rates of Billroth I and Billroth II reconstructions after
LADG.
Patients and methods We retrospectively collected data
from 1,259 patients who underwent LADG performed by
ten surgeons at ten hospitals between April 1998 and
December 2005. Patients were classified into two groups
according to reconstruction method used: the Billroth I
group (n = 875) and the Billroth II group (n = 384).
Patient and tumor characteristics, operative details, and
postoperative complications were analyzed.
Results Billroth II reconstruction was performed on obese
patients (p = 0.003) and patients with more advanced
tumors (p\0.001). Billroth I reconstruction was performed
more frequently in the lower portion of the stomach
(p\0.001) and yielded shorter operating times. The
postoperative complication rate was 11.4% in the Billroth I
group, which was lower than that in the Billroth II group
(16.9%) (p = 0.011). However, the differences in the
major complication rates were not statistically significant
(p = 0.263). Of the intra-abdominal complications, intraluminal
or intraperitoneal bleeding was the most frequent
complication in the Billroth I group and duodenal stump
leakage was the most frequent in the Billroth II group. The
postoperative mortality rate did not show a statistically
significant difference.
Conclusions Both Billroth I and Billroth II techniques are
feasible and safe reconstruction methods after LADG for gastric cancer. To reduce major complication rates, surgeons
should pay attention to bleeding in Billroth I reconstruction
and stump leakage in Billroth II reconstruction.
Keywords Laparoscopic gastrectomy Gastric cancer
Billroth I reconstruction Billroth II reconstruction
Complications
Department
Dept. of Surgery (외과학)
Publisher
School of Medicine
Citation
Kyu-Chul Kang et al. (2011). Comparison of Billroth I and Billroth II reconstructions after laparoscopy-assisted distal gastrectomy: a retrospective analysis of large-scale multicenter results from Korea. Surgical Endoscopy, 25(6), 1953–1961. doi: 10.1007/s00464-010-1493-0
Type
Article
ISSN
0930-2794
DOI
10.1007/s00464-010-1493-0
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/34441
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Surgery (외과학)
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