Billroth I Gastrectomy Using a Circular Stapler to Treat Gastric Cancer

Abstract

We describe herein our technique of performing gastrectomy followed by side-to-end gastroduodenostomy. Because the clamp is removed at the resection line of the greater curvature, there is no need to perform an additional gastrotomy for insertion of the instrument. This feature differentiates our technique from previous methods of anastomosis using the circular stapler. We believe that our technique is superior in simplicity and security to the traditional hand-sewn anastomosis. Moreover, it allows for a shorter operative time. This technique is recommended for practical surgery over conventional techniques.

Safety of modified double‐stapling end‐to‐end gastroduodenostomy in distal subtotal gastrectomy

“…Many articles introduce their anastomotic methods without presenting their detailed clinical results [8][9][10][11]. Our large cohort study evaluating more than 400 gastric cancer patients with a postoperative follow-up of more than 6 months can provide a strong evidence for the safety of this new technique.…”

“…Recently, the circular stapler has been widely used in Billroth I anastomosis [6][7][8][9][10]. However, most techniques used in stapling Billroth I methods are side-to-end gastroduodenostomies (i.e., an anastomosis between the posterior wall of the stomach and the duodenum) and have some disadvantages, including an additional gastrotomy in the remnant stomach and a tenser posterior side of the remnant stomach.…”

A prospective randomized trial of hand-sutured versus mechanically stapled anastomoses for gastroduodenostomy after distal gastrectomy

“…Safer techniques for anastomosis are therefore urgently required. Several techniques have been described for Billroth I reconstruction with a mechanically stapled anastomosis [11,[28][29][30]. Some authors perform anastomosis before gastrectomy, whereas others perform anastomosis to the posterior wall of the residual stomach.…”

Roux-en-Y Gastrojejunostomy Using Modified Hemi-Double Stapling

“…However, the Roux-en-Y reconstruction with a hand-sutured anastomosis requires time and is technically difficult, especially when the operative field is deep. Recently, laparoscopic surgery has been adopted widely for the treatment of gastric cancer, and anastomotic stapling devices are frequently used for reconstruction [6]. The Roux-en-Y anastomosis using a circular stapler is reported to be simple and fast [7].…”