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

被引:56
作者
Kang, Kyu-Chul [1 ]
Cho, Gyu Seok [1 ]
Han, Sang Uk [2 ]
Kim, Wook [3 ]
Kim, Hyung-Ho [4 ]
Kim, Min-Chan [5 ]
Hyung, Woo Jin [6 ]
Ryu, Seong Yeob [7 ]
Ryu, Seung Wan [8 ]
Lee, Hyuk Joon [9 ]
Song, Kyo Young [10 ]
机构
[1] Soonchunhyang Univ, Dept Surg, Bucheon Hosp, Bucheon Si 420767, Gyeonggi Do, South Korea
[2] Ajou Univ Hosp, Dept Surg, Suwon, South Korea
[3] Catholic Univ Korea, Dept Surg, Yeouido St Marys Hosp, Seoul, South Korea
[4] Seoul Natl Univ, Dept Surg, Bundang Hosp, Songnam, South Korea
[5] Dong A Univ, Dept Surg, Coll Med, Pusan, South Korea
[6] Yonsei Univ, Coll Med, Dept Surg, Seoul, South Korea
[7] Chonnam Natl Univ, Coll Med, Dept Surg, Kwangju, South Korea
[8] Keimyung Univ, Dept Surg, Coll Med, Taegu, South Korea
[9] Seoul Natl Univ, Coll Med, Dept Surg, Seoul, South Korea
[10] Catholic Univ Korea, Dept Surg, Seoul, South Korea
来源
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES | 2011年 / 25卷 / 06期
关键词
Laparoscopic gastrectomy; Gastric cancer; Billroth I reconstruction; Billroth II reconstruction; Complications; ROUX-EN-Y; LYMPH-NODE DISSECTION; GASTRIC-CANCER; SUBTOTAL GASTRECTOMY; COMPLICATIONS; TIME;
D O I
10.1007/s00464-010-1493-0
中图分类号
R61 [外科手术学];
学科分类号
摘要
Since reconstruction after laparoscopy-assisted 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. 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. 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. 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.
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收藏
页码:1953 / 1961
页数:9
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