title: Linear-shaped gastroduodenostomy (LSGD): safe and feasible technique of intracorporeal Billroth I anastomosis.
abstract: Although delta-shaped gastroduodenostomy (DSGD) is used increasingly as an intracorporeal Billroth I anastomosis after distal gastrectomy, worries about anatomical distortion always exist in twisting stomach and making an oblique incision on duodenum. We developed a new method of intracorporeal gastroduodenostomy, the linear-shaped gastroduodenostomy (LSGD), in which anastomosis is done using endoscopic linear staplers only without any complicated rotation. In this report, we introduced LSGD and compared its short-term and long-term outcomes with DSGD.
  
  
  
  We analyzed 261 consecutive gastric cancer patients who underwent the intracorporeal gastroduodenostomy between January 2009 and May 2014 (LSGD: 190, DSGD: 71), retrospectively. All of them underwent a laparoscopic or robotic distal gastrectomy with regional lymph node dissection. Early surgical outcomes such as operation time, postoperative complications, days until soft diet began, length of hospital stay, and endoscopic findings in postoperative 6 and 12 months were evaluated.
  
  
  
  Although the proportion of robotic approach and D2 lymphadenectomy were significantly higher in LSGD group, the rates for overall complications (13.2 % [LSGD] vs. 9.9 % [DSGD], p = 0.470) and major complications (5.8 vs. 5.6 %, p = 1.0) were similar between two groups. There were no differences in anastomotic bleeding (1.1 vs. 1.4 %, p = 1.0), stenosis (3.2 vs. 2.8 %, p = 1.0), and leakage (0.5 vs. 0.0 %, p = 1.0). Endoscopy performed 6 months postoperatively showed that residual food (p = 0.022), gastritis (p = 0.018), and bile reflux (42.0 vs. 63.2 %, p = 0.003) were significantly decreased in LSGD and there were no significant differences in postoperative 12 months.
  
  
  
  LSGD is an innovative reconstruction technique with comparable short-term outcomes to DSGD. In addition, reduced residual food, gastritis, and bile reflux were seen in LSGD.
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea.
authors.forename: Cheulsu
authors.initials: C
authors.lastname: Byun
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea.
authors.forename: Long Hai
authors.initials: LH
authors.lastname: Cui
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea.
authors.forename: Sang-Yong
authors.initials: SY
authors.lastname: Son
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Hur
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea.
authors.forename: Young Kwan
authors.initials: YK
authors.lastname: Cho
authors.affiliation: Department of Surgery, Ajou University School of Medicine, San5, Wonchon-Dong, Yeongtong-Gu, Suwon, 443-749, Korea. hansu@ajou.ac.kr.
authors.forename: Sang-Uk
authors.initials: SU
authors.lastname: Han
mesh_terms: D000328:Adult; D000368:Aged; D001655:Bile Reflux / Q000453:epidemiology; D002277:Carcinoma / Q000601:surgery*; D003251:Constriction, Pathologic / Q000453:epidemiology; D004378:Duodenal Diseases / Q000453:epidemiology; D004385:Duodenostomy / Q000379:methods*; D004386:Duodenum / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D005756:Gastritis / Q000453:epidemiology; D005763:Gastroenterostomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D013274:Stomach Neoplasms / Q000601:surgery*
keywords: Delta-shaped gastroduodenostomy; Gastric cancer; Intracorporeal gastroduodenostomy; Intracorporeal reconstruction; Linear-shaped gastroduodenostomy; Minimally invasive surgery