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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
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