To study the clinical effect of first amputation of duodenum in total laparoscopic distal radical gastrectomy for gastric cancer.

From January 2014 to June 2016, 43 patients with distal gastric cancer underwent total laparoscopic radical gastrectomy in our hospital were analyzed retrospectively. According to the different techniques of operation, 23 patients were divided into three-staple cartridge group and 20 patients were divided into four-staple cartridge group. Statistical software SPSS 24.0 was used for data analysis. The perioperative indicators and other measurement data of the two groups were presented as (±s), and the independent sample t test was used for inter-group comparison. The postoperative complications and 3-year survival rate were determined by χ² test. P<0.05, was the test standard.

The operation was successfully completed in both groups. The operation time and anastomotic time of the four-staple cartridge group were shorter than those of the three-staple cartridge group, and the differences were statistically significant (P<0.05). In the comparison of intraoperative blood loss, postoperative first exhaust time and postoperative hospital stay, there was no significant difference between the two groups (P>0.05). The incidence of postoperative complications was 13.0% in the three-pieces group and 15.0% in the four-pieces group, with no significant difference between the two groups (P>0.05). At 6 months after the operation, the incidence of dumping syndrome, intestinal obstruction and other recent complications was 13.0% in the three-pieces group and 10.0% in the four-pieces group, with no significant difference in the incidence of complications between the two groups (P>0.05). The 3-year survival rates of the three-pieces group and four-pieces group were 56.5% and 55.0%, There was no significant difference between the two groups (P>0.05).

In total laparoscopic distal radical gastrectomy first Cut off the duodenal and 4 straight line staple cartridge closures can be used for digestive tract reconstruction. The operation is easier to do and safe and reliable.