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Park, Lee, Kim, and Park: Delta-Shaped Gastroduodenostomy after Totally Laparoscopic Distal Gastrectomy: A Comparison Analysis between Early and Late Experience
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 79(2): 110-115.

Published online: 2 August 2010

DOI: https://doi.org/10.4174/jkss.2010.79.2.110

Delta-Shaped Gastroduodenostomy after Totally Laparoscopic Distal Gastrectomy: A Comparison Analysis between Early and Late Experience

Sung Kyun Park, M.D., Han Hong Lee, M.D.1, Jin-Jo Kim, M.D., Seung-Man Park, M.D.

Department of Surgery, Incheon St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Incheon, Korea.

1Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, School of Medicine, Seoul, Korea.

Corresponding author (kjj@catholic.ac.kr)

Received 27 January 2010       Accepted 14 April 2010

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

We conducted this study to evaluate the feasibility and the safety of a delta-shaped gastroduodenostomy after totally laparoscopic distal gastrectomy (TLDG) and to know about the factors having influence on surgeons' performance of anastomosis and technical details of this operation.

Methods

The clinical characteristics and the surgical results of 57 consecutive patients with delta-shaped gastroduodenostomy after TLDG at Incheon St. Mary's Hospital were reviewed. The patients were divided into 2 groups (before and after 20 cases) and their clinical characteristics and surgical results were compared. The factors which influenced the anastomotic time and the technical details of the operation were also investigated.

Results

There was no difference in age, gender, body mass index, surgical results except for operation time, anastomotic time, and starting day of oral feeding between the 2 groups. The experience of the surgeon was the only factor that influenced the anastomotic time.

Conclusion

Delta-shaped gastroduodenostomy is a feasible and safe procedure even in the early years of a surgeon's career. It could feasibly be done in less than 20 minutes in relatively experienced hands.

Keywords: Totally laparoscopic distal gastrectomy, Billroth-I, Delta-shaped gastroduodenostomy

Figures and Tables

Fig. 1
Trochar placement of a delta-shaped gastroduodenostomy.
jkss-79-110-g001
Fig. 2
Schematic illustrations for a delta-shaped gastroduodenostomy. (A) The duodenum was transected in a vertical direction rather than in the usual direction. (B) Functional end-to-end anastomosis was made between the posterior wall of the remnant stomach and the posterosuperior aspect of the duodenal bulb. (C) The entry hole for the stapler was closed by 2 consecutive staplings.
jkss-79-110-g002
Table 1
Clinical characteristics and surgical results of the patients with a delta-shaped gastroduodenostomy
jkss-79-110-i001
Table 2
The factors influencing the anastomotic time of delta-shaped gastroduodenostomy
jkss-79-110-i002

*The average anastomotic time was 26.3 minutes.

References

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