Comparison of long-term outcomes between Billroth- and Roux-en-Y reconstruction after distal ;gastrectomy
10.3760/cma.j.issn.1671-0274.2014.05.010
- VernacularTitle:远端胃切除术后毕Ⅰ式与Roux-en-Y消化道重建远期疗效的比较
- Author:
Cong MAI
1
;
Yunqiang TANG
;
Hongyu ZHAO
;
Hui TANG
Author Information
1. 510095,广州医科大学附属肿瘤医院腹外二科
- Keywords:
Stomach neoplasms;
Distal gastrectomy;
Digestive tract reconstruction;
Long-term outcomes
- From:
Chinese Journal of Gastrointestinal Surgery
2014;(5):449-452
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the long-term outcomes of Billroth-Ⅰ and Roux-en-Y reconstruction after distal gastrectomy. Methods Clinical data of 151 patients with gastric cancer undergoing distal gastrectomy in the Affiliated Oncologic Hospital of Guangzhou Medical University between June 2000 and June 2010 were analyzed retrospectively . Reconstruction was performed with Billroth-Ⅰ in 87 patients (B-Ⅰgroup) and Roux-en-Y in 64 (R-Y group). All the patients were followed up for at least 3 years. Three years after operation, clinical symptoms, endoscopic findings, nutritional status , gallstone formation , and late gastrointestinal complications were compared between the two groups. Results Three years after operation, gastroesophageal reflux symptoms were found in 10 patients (11.5%) in B-Ⅰ group and in 3 (4.7%) in R-Y group , and dumping syndrome was diagnosed in 8 patients (9.2%) in B-Ⅰ group and in 3 (4.7%) in R-Y group, but the differences between the two groups were not statistically significant(both P>0.05). Endoscopic examination showed that the amount of residue in the gastric stump, remnant gastritis-reflux esophagitis, and bile reflux in R-Y group were better as compared to B-Ⅰ group(all P<0.05). Body weight, serum albumin level, and total cholesterol level were similar in the two groups (all P>0.05). The incidences of gallstone formation and late gastrointestinal complications did not differ between B-Ⅰgroup and R-Y group (13.2% vs. 15.8%, and 8.0% vs. 4.7% respectively, both P>0.05). Conclusion As compared with Billroth-Ⅰ, Roux-en-Y is associated with better long-term outcomes in terms of less remnant gastritis-reflux esophagitis and less bile reflux into the gastric remnant.
