Laparoscopy-assisted Billroth I Gastrectomy Compared with Open Gastrectomy

Yi, Nam Joon; Han, Ho Seong; Kim, Young Woo; Min, Seog Ki; Kim, Eu Gene; Choi, Yong Man

Abstract

PURPOSE: To compare laparoscopy-assisted Billroth I gastrectomy (LABIG) including standard lymph node dissection for patients with early gastric cancer was compared with open gastrectomy as a treatment method.
METHODS
A prospective nonrandomized study was performed of early gastric cancer patients at Ewha Womans University Mok-Dong hospital from July 1999 to May 2001. Twenty patients (Group L) underwent LABIG including standard lymph node dissection. The control group (Group O) comprised 14 patients with conventional open radical subtotal gastrectomy and Billroth I anastomosis.
RESULTS
In group L, pathologic reports revealed 18 early gastric cancers (stage IA 17 cases, IB 1 case), and 2 pm cancers (stage IB 1 case, stage II 1 case). In group O, there were 13 early gastric cancers (stage IA 12 cases, IB 1 case), and 1 pm cancer (stage IB). Significant differences (p<0.05) were present between group L and O in regards to mean operation time (277.5 vs 215.0 minutes), proximal margin (4.8 vs 7.0 cm), distal margin (4.4 vs 3.9 cm), number of harvested lymph nodes (25.6 vs 37.9), frequencies for pain control (7.2 vs 11.0 times), wound size (7.6 vs 20.0 cm) and postoperative hospital stay (13.7 vs 21.9 days). There were no differences in blood loss, transfusion, leukocyte count, time to diet, serum protein, or weight loss. Complications were seen in 2 cases in group L (enterocutaneous fistula, gastric atony), and 2 cases in group O (gastric atony, marginal ulcer with bleeding).
CONCLUSION
LABIG with standard lymph node dissections is a safe and useful technique for the treatment of early gastric cancer with improved postoperative recovery as compared to open conventional gastrectomy.