J Minim Invasive Surg.  2018 Jun;21(2):57-64. 10.7602/jmis.2018.21.2.57.

T-shaped Modified Delta Anastomosis as a Simple Intracorporeal Gastroduodenostomy

• Park CG
• Yang YS
• Lee JM

• KMID: 2436225
• DOI: http://doi.org/10.7602/jmis.2018.21.2.57

Abstract

PURPOSE
A delta-shaped anastomosis (DA) is a widely accepted technique used for a totally laparoscopic distal gastrectomy (TLDG). Several studies have suggested various modifications to overcome the drawbacks of an original DA. We present our novel technique"•a T-shaped modified delta anastomosis (TDA), and we report the early outcomes with its use in a case series.
METHODS
We retrospectively reviewed the medical records of 40 patients who underwent a TLDG with TDA for early gastric cancer at OOO between February 2016 and May 2017. Perioperative outcomes, postoperative complications, and operating time were analyzed, and all data were expressed as means±standard deviation.
RESULTS
We observed no major complications that required immediate postoperative intervention. Other minor and non-surgical complications were delayed gastric emptying (n=1), pneumonia (n=2), atelectasis (n=3), dumping symptom (n=1), and symptomatic bile reflux (n=1). No wound infection was reported in any patient. The total operative time was 206.5±25.4 min and the estimated blood loss was 27.8±33.5 ml. The mean time required to perform the anastomosis was 20.9±6.7 min, and the mean number of cartridges used during the operation was 4.78±0.66.
CONCLUSION
We conclude that a TDA following a laparoscopic distal gastrectomy was successfully developed and showed acceptable clinical outcome.

Keyword

Laparoscopic surgery; Gastroduodenostomy; Intracorporeal anastomosis; Gastric cancer

MeSH Terms

Bile Reflux
Gastrectomy
Gastric Emptying
Humans
Laparoscopy
Medical Records
Operative Time
Pneumonia
Postoperative Complications
Pulmonary Atelectasis
Retrospective Studies
Stomach Neoplasms
Wound Infection