J Korean Surg Soc.  2010 Aug;79(2):110-115. 10.4174/jkss.2010.79.2.110.

Delta-Shaped Gastroduodenostomy after Totally Laparoscopic Distal Gastrectomy: A Comparison Analysis between Early and Late Experience

• Park SK
• Lee HH
• Kim JJ
• Park SM

• KMID: 2211980
• DOI: http://doi.org/10.4174/jkss.2010.79.2.110

Abstract

PURPOSE
We conducted this study to evaluate the feasibility and the safety of a delta-shaped gastroduodenostomy after totally laparoscopic distal gastrectomy (TLDG) and to know about the factors having influence on surgeons' performance of anastomosis and technical details of this operation.
METHODS
The clinical characteristics and the surgical results of 57 consecutive patients with delta-shaped gastroduodenostomy after TLDG at Incheon St. Mary's Hospital were reviewed. The patients were divided into 2 groups (before and after 20 cases) and their clinical characteristics and surgical results were compared. The factors which influenced the anastomotic time and the technical details of the operation were also investigated.
RESULTS
There was no difference in age, gender, body mass index, surgical results except for operation time, anastomotic time, and starting day of oral feeding between the 2 groups. The experience of the surgeon was the only factor that influenced the anastomotic time.
CONCLUSION
Delta-shaped gastroduodenostomy is a feasible and safe procedure even in the early years of a surgeon's career. It could feasibly be done in less than 20 minutes in relatively experienced hands.

Keyword

Totally laparoscopic distal gastrectomy; Billroth-I; Delta-shaped gastroduodenostomy

MeSH Terms

Body Mass Index
Gastrectomy
Hand
Humans

Figure

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  Fig. 1 Trochar placement of a delta-shaped gastroduodenostomy.

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  Fig. 2 Schematic illustrations for a delta-shaped gastroduodenostomy. (A) The duodenum was transected in a vertical direction rather than in the usual direction. (B) Functional end-to-end anastomosis was made between the posterior wall of the remnant stomach and the posterosuperior aspect of the duodenal bulb. (C) The entry hole for the stapler was closed by 2 consecutive staplings.

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