Linear-Shaped Gastroduodenostomy in Totally Laparoscopic Distal Gastrectomy

Abstract

Purpose: Laparoscopic gastrectomy has been common treatment modality for gastric cancer. But, most surgeons tend to perform laparoscopy-assisted distal gastrectomy using epigastric incision. Delta-shaped anastomosis is known as intracorporeal gastroduodenostomy, but it is technically difficult and needed many staplers. So we tried to find simple and economical method, here we report on the results of liner-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy.

Materials and Methods: We retrospectively reviewed the medical records of 25 patients who underwent totally laparoscopic distal gastrectomy using liner-shaped anastomosis at School of Medicine, Ajou University between January to October 2009. The indication was early gastric cancer as diagnosed by preoperative workup, the anastomoses were performed by using laparoscopic linear stapler.

Results: There were 12 female and 13 male patients with a mean age of 55.6±11.2. The following procedures were performed 14 laparoscopic gastrectomies, 11 robotic gastrectomies. The mean operation time was 179.5±27.4 minutes, the mean anastomotic time was 17.5±3.4 minutes. The mean number of stapler cartridges was 5.6±0.8. Postoperative complication occurred in one patient, anastomotic stenosis, and the patient required reoperation to gastrojejunostomy. The mean length of postoperative hospital stay was 6.7±1.0 days except the complication case, and there was no case of conversion to open procedure and postoperative mortality.

Conclusions: Linear-shaped gastroduodenostomy in totally laparoscopic distal gastrectomy is technically simple and feasible method.