title: A modified stapling technique for performing Billroth I anastomosis after distal gastrectomy.
abstract: Autosuture staplers have provided various operative and postoperative benefits in gastrointestinal surgery. We describe herein our technique of performing distal gastrectomy followed by side-to-end gastroduodenostomy. Eighteen consecutive patients with gastric cancer underwent distal gastrectomy by the staple technique. We propose a modification of the stapling technique to reduce the number of devices used. In our technique, side-to-end anastomosis is performed first, followed by gastric resection just distal to the anastomosis. By introducing the stapler through the area to be resected, we can eliminate the need to close the gastrostomy. Anastomotic stricture occurred in only 1 (5.5%) of 18 cases. There have been no other postoperative complications related to the anastomosis. We believe that our technique is superior in simplicity and security to the conventional techniques.
authors.affiliation: Department of Surgery, Tone Chuo Hospital, 1855-1 Higashiharashin-machi, Numata-city, Gunma 378-0053, Japan. yukinao@dream.ocn.ne.jp
authors.forename: Kunio
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Tsuzuki
authors.forename: Tetsu
authors.initials: T
authors.lastname: Ando
authors.forename: Masao
authors.initials: M
authors.lastname: Sekihara
authors.forename: Takashi
authors.initials: T
authors.lastname: Hara
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kori
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nikajima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kuwano
mesh_terms: D005743:Gastrectomy; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling / Q000379:methods*