J Korean Gastric Cancer Assoc.  2009 Jun;9(2):57-62.

Comparison of End-to-side and End-to-end Anastomosis in Circular Stapled Gastroduodenostomy

• Seo MW
• Kim YJ
• Song D
• Kang GH
• Cho GS
• Lee MS
• Hur KY
• Kim JJ

Abstract

PURPOSE: The use of automatic circular staplers for gastroduodenostomy after distal gastrectomy is now widely accepted. We compared the clinical outcomes of two different methods.
MATERIALS AND METHODS
Between March 2005 and February 2008, 134 patients with gastric cancer underwent distal gastrectomies. Seventy-six consecutive patients received end-to-side gastroduodenostomies (ES) between March 2005 and September 2006. The remaining 58 consecutive patients received end-to-end gastroduodenostomies (EE) between November 2006 and February 2008. We analyzed the surgical outcomes between the two groups (ES versus EE) on the basis of prospectively collected data.
RESULTS
Among the clinical factors, there were no differences between the two groups. The overall complication rates were 19.7% in the ES group and 13.8% in the EE group (P=0.489). With respect to anastomosis-related complications, 2 cases had bleeding and 2 cases had stenoses in the ES group, while 2 cases in the EE group had bleeding. Re-operation was needed in the case of intraluminal bleeding in the ES group. There were no mortalities in our study.
CONCLUSION
The two methods for gastroduodenostomy were safe and technically feasible. Although there was no statistical difference in the overall complications, including anastomosis-related complications, we demonstrated better outcomes with respect to anastomotic stenosis in the EE group.

Keyword

Gastroduodenostomy; Complication; End-to-side anastomosis; End-to-end anastomosis

MeSH Terms

Constriction, Pathologic
Gastrectomy
Hemorrhage
Humans
Prospective Studies
Stomach Neoplasms