Kaida Sachiko, Yamaguchi Tsuyoshi, Takebayashi Katsushi, Murata Satoshi, Miyake Toru, Iida Hiroya, Sonoda Hiromichi, Shimizu Tomoharu, Tani Masaji
Department of Surgery, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-city, Shiga, 520-2192, Japan.
Surg Today. 2018 Oct;48(10):909-915. doi: 10.1007/s00595-018-1676-1. Epub 2018 Jun 6.
To classify the shape of the remnant stomach after Billroth-I (B-I) reconstruction and evaluate the relationship between the shape of the remnant stomach and the postoperative clinical outcomes.
One hundred and ninety-five consecutive patients with gastric cancer underwent distal gastrectomy with B-I reconstruction between May 2006 and October 2014. We retrospectively reviewed their medical records and radiological findings. Finally, the shapes of the remnant stomach of 150 patients were classified as either straight type (type A) or stagnant type (type B). The clinical outcomes were compared with respect to the types of remnant stomach.
The incidence of anastomotic leakage was significantly higher in the type A group than in the type B group (9.4 vs. 1.5%, p = 0.044). The body weight change ratio after surgery was significantly lower in the type B group than in the type A group [p = 0.0068, two-way repeated measures analysis of variance (ANOVA)], while the serum albumin levels showed marginally significant improvement in the type B group compared with the type A group (p = 0.0542, two-way repeated measures ANOVA).
The shape of the remnant stomach after distal gastrectomy with B-I reconstruction might influence the degree of anastomotic leakage and long-term nutritional status.
对毕罗一式（B-I）重建术后残胃的形状进行分类，并评估残胃形状与术后临床结局之间的关系。
2006年5月至2014年10月期间，195例连续的胃癌患者接受了B-I重建的远端胃切除术。我们回顾性地查阅了他们的病历和影像学检查结果。最后，将150例患者残胃的形状分为直型（A型）或潴留型（B型）。比较了不同残胃类型的临床结局。
A型组吻合口漏的发生率显著高于B型组（9.4%对1.5%，p = 0.044）。B型组术后体重变化率显著低于A型组[p = 0.0068，双向重复测量方差分析（ANOVA）]，而B型组血清白蛋白水平与A型组相比有轻微显著改善（p = 0.0542，双向重复测量ANOVA）。
B-I重建的远端胃切除术后残胃的形状可能会影响吻合口漏的程度和长期营养状况。
