Roux-en-Y gastrojejunostomy using modified hemi-double stapling.

For reconstruction after distal gastrectomy, the Roux-en-Y gastrojejunostomy is superior to the Billroth II gastrojejunostomy in terms of bile reflux. Roux-en-Y gastrojejunostomy prevents reflux gastritis, esophagitis, and carcinogenesis of the gastric remnant. However, the Roux-en-Y gastrojejunostomy is relatively complicated and lengthy. The authors perform a simple, safe Roux-en-Y gastrojejunostomy using modified hemi-double stapling. We applied this technique to 42 patients with gastric cancer. The average operating and reconstruction times were 172.6 +/- 42.0 and 26.2 +/- 4.8 min, respectively. The postoperative courses were uneventful and the patients were discharged 11.2 +/- 2.4 days postoperatively. Neither leakage nor bleeding from the gastrojejunostomy has occurred postoperatively. The postoperative follow-up was 7-24 months and no local recurrence or stricture at the gastrojejunostomy site occurred. Roux-en-Y gastrojejunostomy using the modified hemi-double stapling technique can achieve reconstruction more simply, safely and quickly, and may provide an alternative reconstruction method for distal gastrectomy. (c) 2009 S. Karger AG, Basel.