Gasless laparoscopic and minilaparotomy Billroth I gastrectomy with hepatectomy for advanced gastric cancer with liver metastasis: Technique and case report

In advanced gastric cancer with solitary liver metastasis, minilaparotomy Billroth I gastrectomy and metastasectomy with laparoscopy was performed by gasless surgery. The patient was a 53-year-old female. Gastroscopic examination revealed gastric cancer (Borrman 3 type) in the antrum, and computed tomography showed a solitary liver metastasis located in segment III. On post-operative day 1, the patient was able to walk. On post-operative day 4 she was started on a clear liquid diet, and was discharged on post-operative day 14. During her post-operative recovery, the patient experienced very little pain. She did not request narcotic analgesia post-operatively.