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Perioperative outcomes of a novel laparoscopic-like "3-arm + 2-port" model in robot-assisted distal gastrectomy in patients with resectable, non-metastatic gastric cancer: a randomized controlled trial.

To compare the perioperative outcomes of a novel laparoscopic-like 3-arm + 2-port and traditional 4-arm + 1-port models in robot-assisted distal gastrectomy with Billroth II reconstruction in patients with resectable, non-metastatic gastric cancer. This randomized controlled trial included patients with resectable, non-metastatic gastric cancer who underwent robot-assisted distal gastrectomy with Billroth II reconstruction with Braun anastomosis and D2 lymphadenectomy. Patients were randomly allocated into two groups based on trocar port placement: traditional 4 + 1 and novel laparoscopic-like

Pylorus-preserving gastrectomy enhances long-term bone health in older adults after gastrectomy.

PURPOSE: Gastrectomy for gastric cancer (GC) can impair gastrointestinal function, leading to malabsorption, bone loss, and vertebral fractures (VFs), especially in older adults. Pylorus-preserving gastrectomy (PPG) may attenuate these metabolic complications. This study compared long-term bone outcomes after laparoscopic distal gastrectomy with Billroth-I reconstruction (LDGBI) versus laparoscopic PPG (LPPG). METHODS: We retrospectively analyzed 75 patients aged ≥75 years with clinical T1N0M0 GC who underwent LDGBI (n = 50) or LPPG (n = 25) between 2005 and 2019. Bone mineral density (BMD) w

Comparative study of the outcomes of robotic versus laparoscopic distal gastrectomy with hand-sewn anastomosis in Billroth-I reconstruction.

PURPOSE: Total laparoscopic distal gastrectomy hand-sewn anastomosis (LDG-HA) for gastric cancer (GC) is safe and effective. The objectives of our study were to investigate the efficacy and safety of laparoscopic versus robotic distal gastrectomy hand-sewn anastomosis (RDG-HA) in Billroth-I reconstruction. METHODS: We retrospectively analyzed the clinical data of 95 patients treated with LDG-HA (n = 55) and RDG-HA (n = 40) for GC from 09/2018 to 06/2021. The effects on baseline, pathology, perioperative data, short-term outcomes, long-term outcomes and 5-year oncologic outcomes follow-up were

A 3-year follow-up study of uncut Roux-en-Y reconstruction: clinical results and outcomes.

BACKGROUND: The goal of this study was to identify the clinical outcomes of uncut Roux-en-Y reconstruction in patients who underwent totally laparoscopic distal gastrectomy (TLDG) over 3-year follow-up. METHODS: From January 2016 to December 2017, 269 patients who underwent TLDG were enrolled in the study and analyzed retrospectively. They were classified into two groups according to the reconstruction method: uncut Roux-en-Y reconstruction (uncut RY) (n = 154) and Billroth II with Braun anastomosis (B-II/Braun) (n = 115). Postoperative endoscopic findings (residual food, bile reflux, gastrit

Comparison of quality of life between Billroth-І and Roux-en-Y anastomosis after distal gastrectomy for gastric cancer: A randomized controlled trial.

Studies comparing Billroth-I (B-I) with Roux-en-Y (R-Y) anastomosis are still lacking and inconsistent. The aim of this trial was to compare the quality of life (QoL) of B-I with R-Y reconstruction after curative distal gastrectomy for gastric cancer. A total of 140 patients were randomly assigned to the B-I group (N = 70) and R-Y group (N = 70) with the comparable baseline characteristics. The overall postoperative morbidity rates were 18.6% and 25.7% in the B-I group and R-Y group without significant difference. More estimated blood loss and longer surgical duration were found in the R-Y gro

Gastroduodenal intussusception due to gastric schwannoma treated by Billroth II distal gastrectomy: one case report.

Schwannomas are rarely observed in the gastrointestinal tract. The most common symptoms of a gastric schwannoma are abdominal pain or dyspepsia, gastrointestinal bleeding, and an abdominal mass. Many gastric schwannomas are asymptomatic and are discovered incidentally or at postmortem. The diagnosis of a schwannoma is based on immunohistochemical positivity for S-100 protein. We present a case report of a rare complication of gastric schwannoma causing gastroduodenal intussusception that was successfully managed by a Billroth II distal gastrectomy. In this rare case, the patient had intermitte

Assessment of postoperative quality of life following pylorus-preserving gastrectomy and Billroth-I distal gastrectomy in gastric cancer patients: results of the nationwide postgastrectomy syndrome assessment study.

BACKGROUND: Pylorus-preserving gastrectomy (PPG) is increasingly being used to treat early gastric cancer in the middle third of the stomach, with the hope of ameliorating postoperative dysfunction and improving quality of life (QOL). We evaluated symptoms of postgastrectomy syndrome (PGS) and QOL by means of a newly developed integrated questionnaire, the Postgastrectomy Syndrome Assessment Scale-45 (PGSAS-45), and compared PPG with Billroth-I distal gastrectomy (DGBI). METHODS: The PGSAS-45 consists of 45 items, including items from the SF-8 and GSRS instruments, as well as 22 newly selecte

Self-expandable metal stents for recurrent malignant obstruction after gastric surgery.

BACKGROUND/AIMS: It is well known that endoscopic insertion of self-expandable metallic stents (SEMS) is safe and effective for the palliative treatment of malignant strictures involving the upper gastrointestinal tract. But, most previous studies focused on stent insertion for esophageal or gastroduodenal obstructions. Only a few cases of stent insertion for recurrent malignant obstruction after gastric cancer surgery have been reported in studies in fewer than 40 patients. The aim of this study was to evaluate the clinical effectiveness of the placement of SEMS in patients with anastomotic r

[Effect of the antrum and vagus nerve on the stimulation of the rat stomach by betazol in the perfusion test].

In the perfusion model on Wistar rats the action of a single s. c. injection of betazol (Histalog) in a dose of 50 mg/kg b. w. in dependence on various types of stomach operations was studied. The following effects were observed: 1. the vagotomy shortly before the perfusion test did not reduce the effect of betazol. 2. If the vagotomy dated back at least 4 weeks, a reduction of the stimulated maximum secretion to half of the controls was seen. 3. The combination of the vagotomy with a pyloroplasty led to a reduction of the stimulated maximum acid secretion to half the amount. Futhermore, the b

Long-term outcomes and quality of life of laparoscopic-assisted pylorus-preserving gastrectomy compared to laparoscopic-assisted distal gastrectomy with billroth I anastomosis for early gastric cancer(pT1N0M0): A Randomized Controlled Trial.

OBJECTIVE: Clarify the long-term outcomes of laparoscopic-assisted pylorus-preserving gastrectomy (LAPPG) compared to conventional laparoscopic-assisted distal gastrectomy with billroth I anastomosis (LADGBI) for early gastric cancer(pT1N0M0). METHODS: Patients with cT1N0M0 cancer located in the middle third of the stomach and not suitable for endoscopic submucosal dissection were randomized to undergo LAPPG or LADGBI. RESULTS: Between August 2017 and October 2019, a total 88 patients (pT1N0M0) were analyzed. The 5-year overall survival rate and disease-free survival rate were 95.5 ​% and 93

[Multicentric gastric carcinoid in autoimmune gastritis].

HISTORY AND FINDINGS: A now 54-year-old woman was 32 years ago found to have immune thrombocytopenia and 3 years ago ANA-positive and HBsAg-negative hepatitis with cirrhotic metaplasia. Numerous small asymptomatic carcinoids with marked hypergastrinaemia (1626 ng/l) were also first found 3 years ago. No gastrinoma could be found. Severe arthralgia was the main symptom on admission. INVESTIGATIONS: Gastroscopy revealed a polypoid carcinoid, 1 cm in diameter. There was total achlorhydria. No pernicious anaemia or carcinoid syndrome was found. TREATMENT AND COURSE: Total gastrectomy with constr

[Effects of total gastrectomy on the nutritional status].

In this study, we have analyzed a series of 88 patients who underwent total gastrectomy followed by two different reconstructive procedures, Roux-en-Y jejunal interposition (57%) and interposition of a jejunal limb between the oesophagus and the duodenum (38%) (Henley procedure). We examined diet, intestinal transit, symptoms of dumping syndrome and body weight curves. Patients with Roux-en-Y reconstruction presented post-prandial sweating more often (48%) than patients with the Henley procedure (21%). Forty percent patients with Roux-en-Y reconstruction suffered post-prandial nausea whereas t

Double barrelled common bile duct: a threat to biliary surgery.

The frequency of cholecystectomies has given the surgeon familiarity and confidence when dealing with biliary anomalies. Internal anomalies are not equally recognized, for they play little role in cholecystectomy. Recognition of internal anomalies is of prime importance, however, when the biliary tree is drained through the gallbladder. Radiographic confirmation of a patent drainage system, avoiding spillage of contrast material, should be routinely employed in these situations to obviate potentially lethal complications due to technical error.

Efficacy and safety of endoscopic ultrasound-guided gastrojejunostomy in patients with malignant gastric outlet obstruction and ascites.

Background and study aims  Endoscopic ultrasound-guided gastrojejunostomy (EUS-GJ) is an endoscopic procedure for treating gastric outlet obstruction (GOO). Limited data exist regarding the safety and efficacy of EUS-GJ in patients with malignant GOO with ascites. Thus, we aimed to study the outcomes and safety of EUS-GJ in GOO patients with vs. without ascites. Patients and methods  This is a retrospective cohort study of patients with malignant GOO who underwent successful EUS-GJ at a tertiary care academic center. Primary outcomes included the efficacy and safety of EUS-GJ. Secondary outcom

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… versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction Endosc Int Open 2017 5 E275 E281 28382326 10.1055/s-0043-101695 PMC5378550 14 Chen Y I James T W Agarwal A EUS-guided gastroenterostomy in management of benign gastric outlet obstruction Endosc Int Open 2018 … /a-0799-9939 PMC6353651 29 Basha J Lakhtakia S Yarlagadda R Gastric outlet obstruction with ascites: EUS-guided gastro-enterostomy is feasible Endosc Int Open 2021 9 E1918 E1923 34917463 10.1055/a-1642-7892 PMC8670992 30 Khashab M A Kumbhari V Grimm I S EUS-guided gastroenterostomy: the first U.S. …

Endoscopic Fistula-jejunostomy for Chronic Gastro-jejunal Fistula After Sleeve Gastrectomy.

INTRODUCTION: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula. MATERIAL AND METHODS: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula. RESULTS: Endoscopic internal drainage (EID) was perfor

Comparison of side-viewing duodenoscope and single-balloon enteroscope to perform ERCP in patients with Billroth II gastrectomy.

Endoscopic retrograde cholangiopancreatography (ERCP) in Billroth II patients is challenging and different endoscopes can be used. We retrospectively analysed 67 ERCP procedures in 38 Billroth II patients focussing on endoscope type and respective technical success and adverse event rate. 33 (49.2 %) ERCPs were performed using a duodenoscope, 87.9 % were successful and 3 were completed with the single-balloon enteroscope. 28 (41.8 %) ERCPs were performed with the single-balloon enteroscope, 82.1 % were successful and 2 were completed with a paediatric colonoscope. For 6 (9.0 %) ERCPs a paediat

A case of gastrojejunocolic fistula with steatohepatitis.

A man in his 30s, who had undergone retrocolic Billroth II reconstruction for perforated duodenal ulcer, presented with watery diarrhea for 2 years and suspected fatty liver. He was referred to our hospital for management of chronic diarrhea, weight loss, hepatopathy and hypoalbuminemia. Initial upper and lower gastrointestinal endoscopies were negative. Since a small bowel lesion was suspected, peroral single-balloon enteroscopy was performed, which identified feces-like residue near the Billroth II anastomotic site and a connection to the colon separate from the afferent and efferent loops.