Comparison Between Billroth-II with Braun and Roux-en-Y Reconstruction After Laparoscopic Distal Gastrectomy

J Gastrointest Surg. 2016 Jun;20(6):1083-90. doi: 10.1007/s11605-016-3138-7. Epub 2016 Apr 11.

Abstract

Purpose: This study aims to compare the effectiveness of Billroth-II with Braun and Roux-en-Y reconstruction after laparoscopic distal gastrectomy.

Methods: From April 2010 to August 2012, 66 patients underwent laparoscopic distal gastrectomy (Billroth-II with Braun reconstruction, 26; Roux-en-Y, 40). The patients' data were collected prospectively and reviewed retrospectively.

Results: The mean operation and reconstruction times were statistically shorter for Billroth-II with Braun reconstruction than Roux-en-Y (198.1 ± 33.0 vs. 242.3 ± 58.1 min, p = 0.001). One case of postoperative stricture was observed in each group. One case each of intra-abdominal abscess and delayed gastric emptying occurred in the Billroth-II with Braun group. At 1 year postoperatively, gastric residue and reflux esophagitis were not significantly different between the groups. Gastritis and bile reflux were more frequently observed in the Billroth-II with Braun group (p = 0.004 and p < 0.001, respectively). At 2 years postoperatively, gastric residue was not significantly different, but gastritis, bile reflux, and esophagitis were more frequent in the Billroth-II with Braun group (p = 0.029, p < 0.001, and p = 0.036, respectively).

Conclusion: The postoperative effectiveness of Roux-en-Y reconstruction may be superior to Billroth-II with Braun reconstruction after laparoscopic distal gastrectomy.

Keywords: Anastomosis; Billroth-II; Gastrectomy; Roux-en-Y.

Publication types

  • Comparative Study

MeSH terms

  • Abdominal Abscess / etiology
  • Aged
  • Anastomosis, Roux-en-Y* / adverse effects
  • Bile Reflux / etiology
  • Constriction, Pathologic / etiology
  • Esophagitis, Peptic / etiology
  • Female
  • Gastrectomy / adverse effects
  • Gastrectomy / methods*
  • Gastric Emptying
  • Gastritis / etiology
  • Gastroenterostomy* / adverse effects
  • Humans
  • Laparoscopy
  • Male
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology*
  • Retrospective Studies
  • Stomach Neoplasms / surgery*