Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy

Koshi Kumagai, Naoki Hiki, Souya Nunobe, Xiaohua Jiang, Takeshi Kubota, Susumu Aikou, Ryohei Watanabe, Shinya Tanimura, Takeshi Sano, Yuukou Kitagawa, Toshiharu Yamaguchi

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. Material and methods: The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. Results: B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15. 2 ± 10. 5 days) than in B-I (12. 8 ± 6. 4 days; P = 0. 034). The incidence of severe complications was higher in R-Y (13. 7%) than in B-I (5. 2%; P = 0. 009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0. 006). Conclusions: The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.

Original languageEnglish
Pages (from-to)2145-2152
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume15
Issue number12
DOIs
Publication statusPublished - 2011 Dec

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Gastroenterostomy
Gastrectomy
Laparoscopy
Stomach Neoplasms
Hernia
Incidence

Keywords

  • Billroth-I
  • Laparoscopy-assisted distal gastrectomy
  • Postoperative complication
  • Reconstruction
  • Roux-en-Y

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy. / Kumagai, Koshi; Hiki, Naoki; Nunobe, Souya; Jiang, Xiaohua; Kubota, Takeshi; Aikou, Susumu; Watanabe, Ryohei; Tanimura, Shinya; Sano, Takeshi; Kitagawa, Yuukou; Yamaguchi, Toshiharu.

In: Journal of Gastrointestinal Surgery, Vol. 15, No. 12, 12.2011, p. 2145-2152.

Research output: Contribution to journalArticle

Kumagai, K, Hiki, N, Nunobe, S, Jiang, X, Kubota, T, Aikou, S, Watanabe, R, Tanimura, S, Sano, T, Kitagawa, Y & Yamaguchi, T 2011, 'Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy', Journal of Gastrointestinal Surgery, vol. 15, no. 12, pp. 2145-2152. https://doi.org/10.1007/s11605-011-1683-7
Kumagai, Koshi ; Hiki, Naoki ; Nunobe, Souya ; Jiang, Xiaohua ; Kubota, Takeshi ; Aikou, Susumu ; Watanabe, Ryohei ; Tanimura, Shinya ; Sano, Takeshi ; Kitagawa, Yuukou ; Yamaguchi, Toshiharu. / Different Features of Complications with Billroth-I and Roux-en-Y Reconstruction After Laparoscopy-Assisted Distal Gastrectomy. In: Journal of Gastrointestinal Surgery. 2011 ; Vol. 15, No. 12. pp. 2145-2152.
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abstract = "Background: This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. Material and methods: The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. Results: B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15. 2 ± 10. 5 days) than in B-I (12. 8 ± 6. 4 days; P = 0. 034). The incidence of severe complications was higher in R-Y (13. 7{\%}) than in B-I (5. 2{\%}; P = 0. 009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0. 006). Conclusions: The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.",
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AU - Hiki, Naoki

AU - Nunobe, Souya

AU - Jiang, Xiaohua

AU - Kubota, Takeshi

AU - Aikou, Susumu

AU - Watanabe, Ryohei

AU - Tanimura, Shinya

AU - Sano, Takeshi

AU - Kitagawa, Yuukou

AU - Yamaguchi, Toshiharu

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N2 - Background: This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. Material and methods: The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. Results: B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15. 2 ± 10. 5 days) than in B-I (12. 8 ± 6. 4 days; P = 0. 034). The incidence of severe complications was higher in R-Y (13. 7%) than in B-I (5. 2%; P = 0. 009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0. 006). Conclusions: The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.

AB - Background: This study investigated differences in the features of postoperative complications between Billroth-I (B-I) and Roux-en-Y (R-Y) reconstructions after laparoscopy-assisted distal gastrectomy (LADG) for early gastric cancer. Material and methods: The study included 424 patients who underwent LADG for cT1, cN0 gastric cancer. Patient characteristics, surgical outcomes, postoperative complications including severity assessment using the Clavien-Dindo classification, and risk factors related to postoperative complications were analyzed. Results: B-I and R-Y were performed in 329 and 95 patients, respectively. Total time in hospital was longer in R-Y (15. 2 ± 10. 5 days) than in B-I (12. 8 ± 6. 4 days; P = 0. 034). The incidence of severe complications was higher in R-Y (13. 7%) than in B-I (5. 2%; P = 0. 009). Three cases of internal hernia and three cases of duodenal stump leakage were observed in R-Y. Univariate analysis revealed the method of reconstruction was a risk factor for severe postoperative complications after LADG (P = 0. 006). Conclusions: The features of postoperative complications are quite different between B-I and R-Y after LADG. Complications after R-Y were more severe than those after B-I. To avoid these severe complications in R-Y, it is necessary to understand these different features.

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