scholarly journals Duodenal stump cancer after Billroth-II distal gastrectomy for gastric cancer

2009 ◽  
Vol 12 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Junhyun Lee ◽  
Kyungji Lee ◽  
Wook Kim
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Duodenal Stump ◽  
Billroth Ii

Endoscopic clipping of duodenal stump leakage after Billroth II gastrectomy in gastric cancer patient

2009 ◽  
Vol 100 (1) ◽  
pp. 80-81 ◽  
Author(s):  
Jong Yeul Lee ◽  
Keun Won Ryu ◽  
Soo-Jeong Cho ◽  
Chan Gyoo Kim ◽  
Il Ju Choi ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Cancer Patient ◽  
Gastric Cancer Patient ◽  
Duodenal Stump ◽  
Billroth Ii ◽  
Billroth Ii Gastrectomy ◽  
Duodenal Stump Leakage ◽  
Endoscopic Clipping

scholarly journals Duodenal Stump Reinforcement with Purse-string Suture in Distal Gastrectomy under Laparoscope Combined with Uncut Roux-en-Y Reconstruction in Patients with Gastric Cancer

2020 ◽  
Author(s):  
Fengyuan Li ◽  
Jianghao Xu ◽  
Hao Xu ◽  
Weizhi Wang ◽  
Diancai Zhang ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Patient Outcomes ◽  
Distal Gastrectomy ◽  
Patient Characteristics ◽  
Linear Stapler ◽  
Duodenal Stump ◽  
Purse String Suture ◽  
Purse String ◽  
Significant Difference ◽  
Duodenal Stump Leakage

Abstract Background: This study aimed to compare patient outcomes after laparoscopic distal gastrectomy with uncut Roux-en-Y reconstruction for gastric cancer between a group who underwent a duodenal stump reinforcement procedure and those who did not.Methods: Data from 233 patients with gastric cancer (GC) undergoing distal gastrectomy under laparoscope combined with uncut Roux-en-Y reconstruction were retrospectively investigated. Patients were divided into two groups. The non-reinforcement group (NR) underwent surgery from June 2014 to March 2015 with no reinforcement of the duodenal stump (n=54) and the reinforcement group (R) underwent surgery from April 2015 to June 2018 with reinforcement of the duodenal stump (n=179). In group R, the duodenum was divided using an endoscope-assisted linear stapler, which was reinforced by a purse-string suture along the duodenal staple line. Results: Duodenal stump leakage was observed in 2 patients from group NR (3.7%), while no duodenal stump leakage or fistula was detected in group R. In addition, no significant difference was observed in the patient characteristics between group NR and R.Conclusions: The incidence of duodenal stump leakage can be reduced by reinforcement with a purse-string suture.

Initial outcomes assessment of Billroth II – Braun anastomosis in laparoscopic distal gastrectomy for cancer

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Ngọc Hùng Đặng ◽  
Keyword(s):  
Gastric Cancer ◽  
Medical Treatment ◽  
Distal Gastrectomy ◽  
Good Choice ◽  
Laparoscopic Distal Gastrectomy ◽  
Common Disease ◽  
Billroth Ii ◽  
Digestive Cancers ◽  
Postoperative Symptoms ◽  
Braun Anastomosis

Abstract Introduction: Gastric cancer is a common disease in the world, among the leading digestive cancers. Until now, surgery, especially laparoscopic surgery, is the primary radical treatment. In there, reestablishment of the gastrointestinal continuity remains controversial. Patients and Methods: A prospective study on 42 patients who underwent laparoscopic distal gastrectomy with Billroth II – Braun anastomosis from October 2019 to June 2020. Results: The post-gastrectomy syndrome with persistent diarrhea accounted for 9.52%; alkaline gastritis accounted for 4.76%. Patients with Grade 2 according to Clavien - Dindo classification accounted for 14.28%. Most patients were with good surgical results of VISICK I (71.44%). 14.28% was with quite good results (VISICK II) and moderate results accounted for 14.28% (VISICK III). There was no case of persistent medical treatment or reoperation. Conclusions: Billroth II - Braun anastomosis is a good choice in laparoscopic distal gastrectomy for cancer with low rate of complications and mild postoperative symptoms that could be easily controlled with short-term medical treatment. Key word: Billroth II – Braun, gastric cancer, distal gastrectomy. Tóm tắt Đặt vấn đề: Ung thư dạ dày là bệnh lý thường gặp trên thế giới, đứng hàng đầu trong các ung thư tiêu hóa. Hiện nay, điều trị ung thư dạ dày (UTDD) bằng phẫu thuật, đặc biệt phẫu thuật nội soi, là phương pháp điều trị triệt căn hàng đầu. Trong đó, tái lập lưu thông tiêu hóa là vấn đề còn đang thảo luận. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả tiến cứu trên 42 người bệnh (NB) UTDD được cắt bán phần dạ dày phần xa bằng phẫu thuật nội soi (PTNS), tái lập bằng miệng nối bilroth II - Braun từ tháng 10/2019 đến tháng 6/2020 và đánh giá kết quả miệng nối Bilroth II (polyA) - Braun trong tái lập lưu thông tiêu hóa sau cắt bán phần xa dạ dày nội soi do ung thư. Kết quả: Hội chứng sau cắt dạ dày với tiêu chảy kéo dài tỷ lệ 9,52%; viêm dạ dày do kiềm chiếm 4,76%. Các NB có độ 2 theo Clavien - Dindo là 14,28%. Phần lớn BN có kết quả phẫu thuật tốt đạt VISICK I (71,44%). 14,28% đạt kết quả khá (VISICK II) và kết quả trung bình là 14,28% (VISICK III). Không có trường hợp cần dùng thuốc dài ngày hay mổ lại. Kết luận: Miệng nối Bilroth II - Braun là một lựa chọn tốt trong phẫu thuật cắt bán phần xa dạ dày do ung thư với tỷ lệ biến chứng sau mổ thấp và các triệu chứng mắc phải sau phẫu thuật thường nhẹ, có thể dễ dàng kiểm soát bằng điều trị nội khoa ngắn ngày. Từ khóa: Billroth II - Braun, ung thư dạ dày, cắt bán phần dạ dày.

scholarly journals Gastric cancer surgery: Billroth I or Billroth II for distal gastrectomy?

BMC Cancer ◽  
2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Birendra K Sah ◽  
Ming-Min Chen ◽  
Min Yan ◽  
Zheng-Gang Zhu
Keyword(s):  
Gastric Cancer ◽  
Distal Gastrectomy ◽  
Cancer Surgery ◽  
Billroth Ii ◽  
Gastric Cancer Surgery ◽  
Billroth I

scholarly journals Two cases of a perforated duodenal diverticulum after gastrectomy with Roux-en-Y reconstruction

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
Shusuke Yagi ◽  
Satoshi Ida ◽  
Manabu Ohashi ◽  
Koshi Kumagai ◽  
Naoki Hiki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Abdominal Pain ◽  
Distal Gastrectomy ◽  
Fluid Collection ◽  
Duodenal Diverticulum ◽  
Surrounding Tissue ◽  
Emergency Laparotomy ◽  
Duodenal Stump ◽  
Reconstruction Procedure ◽  
Cancer Multiple

Abstract Background What type of reconstruction procedure should be applied is one of the important issues in surgery for gastric cancer. We have several options for reconstruction procedure after distal gastrectomy. The Billroth II and Roux-en-Y reconstruction have a duodenal stump while the Billroth I does not have it, which is the biggest structural difference in these procedures. An increase in intraduodenal pressure due to the formation of duodenum stump occasionally causes severe complication such as duodenal stump leakage; however, a duodenal diverticulum perforation after the Roux-en-Y reconstruction has not yet been reported. Herein, we report two cases of a perforated duodenal diverticulum after gastrectomy with the Roux-en-Y reconstruction. Case presentation The first case was a 66-year-old man who presented to our hospital with an acute onset right-upper-quadrant abdominal pain. He had undergone laparoscopic distal gastrectomy with the Roux-en-Y reconstruction for the early gastric cancer 15 months before. A large periampullary diverticulum had been detected during the checkup before the gastrectomy. Abdominal contrast-enhanced CT showed a retroperitoneal fluid collection with gas present at the second part of the duodenum. Therefore, a perforated duodenal diverticulum with abdominal abscess was diagnosed, and an emergency laparotomy was performed. Pancreaticoduodenectomy was performed because of severe duodenal inflammation and surrounding tissue damage. The second case was a 52-year-old man who had undergone open distal gastrectomy for locally advanced gastric cancer. Multiple non-ampullary duodenal diverticula had also been identified during the preoperative checkup. On the 2nd postoperative day, he presented with a sudden-onset abdominal pain with peritoneal irritation signs, and intestinal fluid was identified through the intraperitoneal drainage tube placed in a suprapancreatic site during his previous gastrectomy. Therefore, an emergency laparotomy was performed. During laparotomy, a perforated diverticulum at the second part of the duodenum was detected. The perforated duodenum diverticulum was directly sutured with drainage of the retroperitoneal space. Conclusions It is necessary to recognize that the Roux-en-Y reconstruction after gastrectomy for gastric cancer patients with duodenal diverticulum might cause a perforation of the diverticulum.

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