Christodoulidis Grigorios, Kouliou Marina Nektaria, Koumarelas Konstantinos Eleftherios, Argyriou Konstantinos, Karali Garyfallia Apostolia, Tepetes Konstantinos
Department of General Surgery, University Hospital of Larissa, Larissa 41110, Greece.
Department of Gastroenterology, University Hospital of Larissa, Larissa 41334, Greece.
World J Methodol. 2024 Mar 20;14(1):89709. doi: 10.5662/wjm.v14.i1.89709.
The surgeon performing a distal gastrectomy, has an arsenal of reconstruction techniques at his disposal, Billroth II among them. Braun anastomosis performed during a Billroth II procedure has shown evidence of superiority over typical Billroth II, in terms of survival, with no impact on postoperative morbidity and mortality.
To compare Billroth II Billroth II and Braun following distal gastrectomy, regarding their postoperative course.
Patients who underwent distal gastrectomy during 2002-2021, were separated into two groups, depending on the surgical technique used (Billroth II: 74 patients and Billroth II and Braun: 28 patients). The daily output of the nasogastric tube (NGT), the postoperative day that NGT was removed and the day the patient started per os feeding were recorded. Postoperative complications were at the same time noted. Data were then statistically analyzed.
There was difference in the mean NGT removal day and the mean start feeding day. Mean total postoperative NGT output was lower in Braun group (399.17 mL 1102.78 mL) and it was statistically significant ( < 0.0001). Mean daily postoperative NGT output was also statistically significantly lower in Braun group. According to the postoperative follow up 40 patient experienced bile reflux and alkaline gastritis from the Billroth II group, while 9 patients who underwent Billroth II and Braun anastomosis were presented with the same conditions ( < 0.05).
There was evidence of superiority of Billroth II and Braun typical Billroth II in terms of bile reflux, alkaline gastritis and NGT output.
实施远端胃切除术的外科医生有多种重建技术可供选择，毕罗Ⅱ式吻合术便是其中之一。在毕罗Ⅱ式手术中进行的布朗吻合术在生存率方面已显示出优于典型毕罗Ⅱ式吻合术的证据，且对术后发病率和死亡率无影响。
比较远端胃切除术后毕罗Ⅱ式、毕罗Ⅱ式与布朗吻合术的术后病程。
将2002年至2021年期间接受远端胃切除术的患者，根据所采用的手术技术分为两组（毕罗Ⅱ式：74例患者；毕罗Ⅱ式与布朗吻合术：28例患者）。记录鼻胃管（NGT）的每日引流量、拔除NGT的术后天数以及患者开始经口进食的天数。同时记录术后并发症。然后对数据进行统计学分析。
在NGT拔除平均天数和开始进食平均天数方面存在差异。布朗吻合术组术后NGT总引流量均值较低（399.17 mL vs 1102.78 mL），且具有统计学意义（P<0.0001）。布朗吻合术组术后NGT每日引流量均值也具有统计学意义的更低。根据术后随访，毕罗Ⅱ式组有40例患者出现胆汁反流和碱性胃炎，而接受毕罗Ⅱ式与布朗吻合术的9例患者出现相同情况（P<0.05）。
在胆汁反流、碱性胃炎和NGT引流量方面，有证据表明毕罗Ⅱ式与布朗吻合术优于典型毕罗Ⅱ式吻合术。
