Ann Surg Treat Res.  2022 Aug;103(2):81-86. 10.4174/astr.2022.103.2.81.

Comparison of gastric-jejunum pouch anastomosis and Billroth-II reconstructions after distal gastrectomy: a propensity score matching analysis

• Chen G
• Cheng L
• Liu L
• Luo G
• Li M
• Wen Y
• Wang T
• Cao Y

• KMID: 2532362
• DOI: http://doi.org/10.4174/astr.2022.103.2.81

Abstract

Purpose
Our study aimed to make a propensity score matching (PSM) analysis on the clinical application of gastricjejunum pouch anastomosis (GJPA) and Billroth-II anastomosis after distal gastrectomy.
Methods
We collected clinical data from 249 patients who received distal gastrectomy from January 2016 to July 2020. According to the reconstruction method used, all patients were divided into the Billroth-II group and the GJPA group. Clinical data and operation complications were analyzed.
Results
The clinical characteristics of the 2 groups were comparable after PSM. In the Billroth-II group, the incidence rate of delayed gastric emptying was higher than that in the GJPA group. Fewer patients suffered reflux gastritis in the GJPA group. The RGB (residue, gastritis, and bile) scores related to the severity of bile reflux into the remnant stomach, gastritis, and residue were higher in the Billroth-II group. Postoperative nutritional status and Visick classification demonstrated that postoperative subjective feelings in the GJPA group were improved significantly.
Conclusion
The application of GJPA in reconstruction after distal gastrectomy is safe, economical, and reliable. This reconstruction improved the quality of life of patients. It is worth popularizing widely in clinical settings.

Keyword

Billroth-II reconstruction; Gastrectomy; Gastric-jejunum pouch anastomosis; Stomach neoplasms

Figure

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  Fig. 1 (A) Billroth-II reconstruction. a, Treitz ligament; b, gastrointestinal anastomosis; and c, residual stomach. (B) Gastric-jejunum pouch anastomosis reconstruction. a, Treitz ligament; b, jejunal pouch (6 cm); c, gastrointestinal anastomosis; and d, residual stomach.

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