Title: Clinical effect of BillrothIand Roux-en-Y reconstruction after distal gastrectomy
Abstract: Objective To determine the clinical efficacy of Billroth I and Roux-en-Y reconstruction (RY) after distal gastrectomy.Methods A total of 53 patients were prospectively randomized to either B-l(n=28) or RY reconstruction (n=25)group,and complications and postoperative course were compared.Bile reflux and inflammation in the remnant stomach and lower esophagus were evaluated by postoperative follow-up endoscopy at 6 months.Results Operative time and blood loss as well as postoperative nutrition did not show significant differences between the two groups.As antici- pated,5 of 25 patients with RY reconstruction developed gastrojejunal stasis in the early postoperative period,which led to a longer postoperative hospital stay compared with the B-I group (18.00±5.20 vs 32.80±23.60 days)(P<0.05) .Endoscopic examination revealed that the degree of inflammation in the remnant stomach was lower in the RY group compared with the B-I group (P<0.05) .However,inflammatory findings in the lower esophagus were observed in 8 (28.57%)of B-I,and 8 (32.00%) of the RY group.Conclusion Roux-en-Y reconstruction is effective in preventing duodenogastric reflux and resulting gastritis,but it does not prevent esophagitis.Furthermore,RY reconstruction induces the frequent complication of Roux-en-Y stasis,causing longer postoperative hospital stay.This method has limited ad- vantages over B-I anastomosis after distal gastrectomy.
Publication Year: 2006
Publication Date: 2006-01-01
Language: en
Type: article
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