Safety of modified double-stapling end-to-end gastroduodenostomy in distal subtotal gastrectomy.
OBJECTIVE
Double-stapling end-to-end gastroduodenostomy (DS-BI) has several potential advantages over other anastomotic techniques in that it is a simple procedure, with no additional gastrotomy on the remnant stomach, and less tension on the anastomosis site. We evaluated the safety of DS-BI by comparing it with the hand-sewn Billroth II gastrojejunostomy (B-II).


METHODS
Medical records of 933 consecutive patients (DS-BI 428, B-II 505) who underwent distal subtotal gastrectomy were retrospectively reviewed. Several clinicopathological features and treatment results were compared between the two groups.


RESULTS
The overall complication rates were 9.3% in the DS-BI group and 15.2% in the B-II group (P = 0.007). Anastomosis-related complications, such as anastomosis-site leakage, stenosis, and intraluminal bleeding, did not differ between the two groups (1.2% in the DS-BI group and 1.8% in the B-II group, P = 0.59). All the anastomosis-related complications were managed conservatively. Postoperative mortality rates were 0% in the DS-BI group and 0.4% (2/505) in the B-II group.


CONCLUSIONS
Modified DS-BI is a safe procedure, with short-term results similar to those of hand-sewn Billroth II anastomosis.
Yang
Han-Kwang
HK
Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
Lee
Hyuk-Joon
HJ
Ahn
Hye-Sung
HS
Yoo
Moon-Won
MW
Lee
In Kyu
IK
Lee
Kuhn Uk
KU
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D004385:Duodenostomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000601:surgery*; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods*