Intracorporeal Isosceles Right Triangle-shaped Anastomosis in Totally Laparoscopic Distal Gastrectomy

Kenichi Nakamura, Koichi Suda, Atsushi Suzuki, Masaya Nakauchi, Susumu Shibasaki, Kenji Kikuchi, Tetsuya Nakamura, Shinichi Kadoya, Kazuki Inaba, Ichiro Uyama

Research output: Contribution to journalArticle

2 Citations (Scopus)


Purpose: This study aimed to evaluate the feasibility and safety of intracorporeal anastomosis with Billroth I, Billroth II, or Roux-en-Y reconstructions in totally laparoscopic distal gastrectomy. Materials and Methods: A single-institution, retrospective, cohort study including 553 patients was conducted. Intracorporeal isosceles right triangle-shaped anastomosis without slack and torsion was created using linear staplers. Billroth I was primarily used. Surgical outcomes and perioperative nutritional status were assessed. Results: Morbidity was 11.5%. Postoperative early complications related to anastomosis occurred in 13 patients (2.4%). Operative time and reconstruction type (Billroth I vs. others) were the only significant independent risk factors determining postoperative early and late complications, respectively. No difference was observed in postoperative changes in nutritional status across the groups, although Billroth II increased reflux esophagitis requiring medication. Conclusions: Intracorporeal isosceles right triangle-shaped anastomosis using linear staplers in totally laparoscopic distal gastrectomy, in combination with our selection algorithm for type of reconstruction, is feasible and safe.

Original languageEnglish
Pages (from-to)193-201
Number of pages9
JournalSurgical Laparoscopy, Endoscopy and Percutaneous Techniques
Issue number3
Publication statusPublished - 01-01-2018

All Science Journal Classification (ASJC) codes

  • Surgery

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