Long-Term Comparison of Boomerang-Shaped Jejunal Interposition and Billroth-I Reconstruction After Distal Gastrectomy

Background Billroth-I (BI) is a simple, physiological method of reconstruction following distal gastrectomy. In actuality, postoperative QOL is by no means favorable due to the high incidence of post-gastrectomy syndrome. The aim of this study is to assess the safety and efficacy of boomerang-shaped...

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Bibliographic Details
Published in:World journal of surgery 2015-05, Vol.39 (5), p.1127-1133
Main Authors: Sasaki, Kinro, Miyachi, Kazuhito, Yoda, Norihito, Onodera, Shinichi, Satomura, Hitoshi, Otsuka, Kichiro, Nakajima, Masanobu, Yamaguchi, Satoru, Sunagawa, Masakatsu, Kato, Hiroyuki
Format: Article
Language:English
Subjects:
Abdominal Surgery
Aged
Anastomosis, Surgical - adverse effects
Anastomosis, Surgical - methods
Bile Reflux
Bile Reflux - etiology
Cardiac Surgery
Distal Gastrectomy
Early Gastric Cancer
Eating
Endoscopy, Gastrointestinal
Esophagitis, Peptic - etiology
Female
Follow-Up Studies
Gastrectomy - adverse effects
Gastric Remnant
Gastritis - etiology
Gastroenterostomy - adverse effects
General Surgery
Heartburn - etiology
Humans
Jejunum - surgery
Male
Medicine
Medicine & Public Health
Middle Aged
Original Scientific Report
Postgastrectomy Syndromes - etiology
Postoperative Complications - surgery
Reflux Esophagitis
Stomach - surgery
Stomach Neoplasms - surgery
Surgery
Thoracic Surgery
Time Factors
Vascular Surgery
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Summary:Background Billroth-I (BI) is a simple, physiological method of reconstruction following distal gastrectomy. In actuality, postoperative QOL is by no means favorable due to the high incidence of post-gastrectomy syndrome. The aim of this study is to assess the safety and efficacy of boomerang-shaped jejunal interposition (BJI) after distal gastrectomy. Methods Sixty-six patients with early gastric cancer underwent the BI procedure ( n  = 33) or BJI ( n  = 33) after distal gastrectomy, following which they were compared for 5 years. Tumor characteristics, operative details, postoperative complications and complaints, number of meals, and body weight were analyzed. Patients were followed up by endoscopy every 12 months. Results There were no significant differences in the incidence of postoperative complications. The incidence of heartburn (30 vs. 0 %, P  = 0.0009) and oral bitterness (33 vs. 6 %, P  = 0.0112) were significantly lower in the BJI cases. Endoscopic findings revealed significantly lower incidences of reflux esophagitis (24 vs. 0 %, P  = 0.0051) and remnant gastritis (70 vs. 3 %, P  
ISSN:0364-2313
1432-2323
DOI:10.1007/s00268-015-2941-8