Double Tract Reconstruction After Gastrectomy Facilitates Endoscopic Access to the Biliary Tree
Department of Surgery, Kochi Medical School, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan, .Digestive Diseases and Sciences (Impact Factor: 2.61). 11/2012; 58(5). DOI: 10.1007/s10620-012-2498-4
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ABSTRACT: Many patients undergo gastrectomy every year with a risk of duodenal stump blowout. We compared the conventional surgical techniques with a new and simple method of reconstruction to prevent this complication. We reviewed the medical records of all the patients who underwent gastrectomy from 2002 to 2013 (total or partial distal gastrectomies with Billroth II, Roux-en-Y, and our new technique of reconstruction) in Shohada Tajrish University hospital, Tehran, Iran. A total of 179 patients were eligible for the study: 101 had undergone the new technique (study group) and 78 had undergone the conventional methods (control group). There were three cases of duodenal stump blowout, all in the control group (4 %, P < 0.05). One was fatal (1 %). The post-operative hospital stay was significantly shorter in the study group (8.93 vs. 11.51 days, P < 0.05). Our results show that this new technique can effectively prevent duodenal stump blowout. Other advantages of this technique include the maintenance of physiological passage of food and a safe route for future diagnostic and therapeutic endoscopic interventions. We present a simple technique that eliminates the risk of duodenal stump blowout. Randomized controlled trials are necessary to confirm our findings.
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