BACKGROUND We invented a simple and secure method of intracorporeal gastroduodenostomy, the delta-shaped anastomosis (DA), using endoscopic linear stapler only and standardized the DA procedure by resecting two-thirds of the stomach based on the anatomical landmarks. This study aimed to evaluate the feasibility of the standardized DA as the standard reconstruction procedure after a laparoscopic distal gastrectomy assessing functional outcomes including postoperative complications, body weight loss, nutritional status, and endoscopic findings. METHODS The medical records of 349 patients with gastric cancer who underwent laparoscopic distal gastrectomy from April 2011 to December 2017 at our hospital were retrospectively reviewed. Functional outcomes were assessed according to nutritional status and endoscopic findings. RESULTS The operation time was shorter and complication rate was lower in the standardized DA than those in Billroth-II (BII) and Roux-en-Y (RY). The body weight loss in DA was 10% 1 year postoperatively and remained stable during the follow-up period, which showed no significant difference. The endoscopic findings showed the ratio of residual food in DA was lower than that in RY (DA:RY = 13.3%:13.6% and 8.4%:33.3% at 1 and 3 years postoperatively, respectively). Severe gastritis was extremely rare in DA (6.7% at 1 year and 15.6% at 3 years postoperatively). Bile reflux was more often found in DA than RY (DA:RY = 19.9%:4.8% and 26.6%:0% at 1 and 3 years postoperatively, respectively). Reflux esophagitis was found 10% of DA only. CONCLUSIONS Functional outcomes of the standardized DA were satisfactory and feasible. Our intracorporeal Billroth-I reconstruction, by resecting two-thirds of the stomach, can be one of the standard reconstruction methods after a laparoscopic distal gastrectomy.

中文翻译：

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腹腔镜远端胃切除术后三角吻合的功能结果。


背景我们发明了一种简单、安全的胃十二指肠体内吻合术——三角吻合术（DA），仅使用内窥镜线性吻合器，并根据解剖标志切除三分之二的胃，标准化了DA手术。本研究旨在评估标准化 DA 作为腹腔镜远端胃切除术后标准重建程序的可行性，评估功能结果，包括术后并发症、体重减轻、营养状况和内镜检查结果。方法回顾性分析2011年4月至2017年12月在我院行腹腔镜远端胃切除术的349例胃癌患者的病历。根据营养状况和内窥镜检查结果评估功能结果。结果标准化DA比Billroth-II (BII)和Roux-en-Y (RY)手术时间更短，并发症发生率更低。术后1年DA体重减轻10%，随访期间保持稳定，无显着差异。内镜检查结果显示，DA中残留食物的比例低于RY（术后1年和3年时DA：RY分别为13.3％：13.6％和8.4％：33.3％）。 DA 中严重胃炎极为罕见（术后 1 年为 6.7%，术后 3 年为 15.6%）。胆汁反流在 DA 中比 RY 中更常见（术后 1 年和 3 年时 DA:RY 分别为 19.9%:4.8% 和 26.6%:0%）。发现反流性食管炎的DA仅占10%。结论 标准化 DA 的功能结果是令人满意且可行的。 我们的体内 Billroth-I 重建通过切除三分之二的胃，可以成为腹腔镜远端胃切除术后的标准重建方法之一。