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Chinese Journal of Operative Procedures of General Surgery(Electronic Edition) ›› 2023, Vol. 17 ›› Issue (04): 368-371. doi: 10.3877/cma.j.issn.1674-3946.2023.04.004

Special Issue:

• Commentary • Previous Articles     Next Articles

Selection and strategy of digestive tract reconstruction after laparoscopic distal gastrectomy

Xiangqian Su(), Tongkun Song, Kai Xu   

  1. Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital & Institute, Beijing 100080, China
  • Online:2023-08-26 Published:2023-07-28
  • Contact: Xiangqian Su
  • Supported by:
    National Natural Science Foundation of China(82171720, 81872022); Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(ZYLX202116)

Abstract:

Laparoscopic distal gastrectomy is the main surgical method for lower gastric cancer. As an important part of surgery,digestive tract reconstruction directly affects the postoperative quality of life of patients. BillrothⅠanastomosis,BillrothⅡanastomosis,Roux-en-Y anastomosis and their corresponding improved methods,Braun anastomosis and Uncut Roux-en-Y anastomosis,are the main reconstruction methods at present. The BillrothⅠanastomosis was physiologically consistent,but was limited by the size and location of the primary tumor. BillrothⅡanastomosis had no tumor staging requirements and solved the problem of anastomotic tension. After combined Braun anastomosis,the risk of postoperative reflux gastritis was significantly reduced. Roux-en-Y anastomosis completely solved bile reflux gastritis,but the operation was complicated and the intestinal continuity was damaged,which was prone to Roux-en-Y stasis syndrome after surgery. Although Uncut Roux-en-Y anastomosis may cause recanalization of the afferent limb,it is still a relatively ideal reconstruction method.

Key words: Laparoscopy, Distal Gastrectomy, Digestive Tract Reconstruction

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