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Zhang et al. Mini-invasive Surg 2019;3:2                       Mini-invasive Surgery
               DOI: 10.20517/2574-1225.2018.64




               Review                                                                        Open Access


               Current status of technique for Billroth-I
               anastomosis in totally laparoscopic distal
               gastrectomy for gastric cancer

               Shun Zhang , Tetsu Fukunaga 1
                          1,2
               1 Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University Hospital, Tokyo 113-8421, Japan.
               2 Department of Gastroenterology Surgery, Shanghai East Hospital, Shanghai 200120, China.

               Correspondence to: Dr. Tetsu Fukunaga, Department of Gastroenterology and Minimally Invasive Surgery, Juntendo University
               Hospital, 3-1-3 Hongo, Bunkyo-ku, Tokyo, Japan. E-mail: t2fukunaga@juntendo.cac.jp

               How to cite this article: Zhang S, Fukunaga T. Current status of technique for Billroth-I anastomosis in totally laparoscopic
               distal gastrectomy for gastric cancer. Mini-invasive Surg 2019;3:2. http://dx.doi.org/10.20517/2574-1225.2018.64

               Received: 2 Oct 2018    First Decision: 23 Oct 2018    Revised: 19 Dec 2018    Accepted: 24 Dec 2018    Published: 14 Jan 2019
               Science Editor: Tetsu Fukunaga    Copy Editor: Cui Yu    Production Editor: Huan-Liang Wu



               Abstract
               Several reconstruction techniques are possible after totally laparoscopic distal radical gastrectomy. An optimal technique
               of digestive tract reconstruction after distal gastrectomy has not yet been established. The ideal reconstruction should
               be not only for doctors but also for patients. Alimentary intake, satisfactory nutritional status and easy performing
               should be all considered. The aim of the study was to describe the different Billroth-I reconstruction techniques that can
               be proposed after totally laparoscopic distal radical gastrectomy.

               Keywords: Billroth-I anastomosis, totally laparoscopic distal gastrectomy, gastric cancer




               INTRODUCTION
                                                                                          [1]
               In 1994, Kitano firstly reported the technique for laparoscopy assisted Billroth-I (B-I) . Since then, the
               use of laparoscopic treatments for gastric cancer is increasing due to the advantages of improving patients’
               quality of life. The new technologies and improved techniques have allowed laparoscopy gastrectomy to
               expand its indications and also to use this treatment for more complex cases. Japan Society of Endoscopic
               Surgery (JSES) conducted national survey every 2 years and indicated the percentage of laparoscopic
               procedures for gastric cancer was increasing. According to the 12th JSES survey, laparoscopic distal
                                                                                           [2]
               gastrectomy (LDG) was the most commonly performed type of laparoscopic gastrectomy .

               In initial series for LDG, the majority of anastomoses were performed by laparoscopy assisted procedures.

                           © The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
                           International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
                sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
                as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
                and indicate if changes were made.


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