Feasibility Of Delta-Shaped Gastroduodenostomy In Totally Laparoscopic Distal Gastrectomy For Gastric Cancer

Objective:To investigate the feasibility of delta-shaped（DS）gastroduodenostomy in totally laparoscopic distal gastrectomy（TLDG）for gastric cancer.Methods:From July 2013 to March 2016,66 gastric cancer patients underwent DS gastroduodenostomy using laparoscopic linear stapler.All of them underwent TLDG with D₂ lymphadenectomy.In addition,―Modified DS anastomosis‖（when closing the common entry hole,previous duodenal staple line was also removed）was selectively used.Clinical data of these 66 patients was retrospectively analyzed.Results:All these 66 patients successfully underwent TLDG with D₂ lymphadenectomy and DS gastroduodenostomy.Among them,17 patients underwent modified DS anastomosis.The total operating time was（173.0±36.4）min,and the time required for the DS anastomosis was（12.8±9.4）min.The number of linear stapler cartridges used per patient was 5.8±0.8.The intraoperative blood loss was（52.3±34.1）ml,the number of lymph nodes harvested per patient was 31.8±13.3,and all these 66 patients achieved microscopic cancer-free resection margin.The number of days to the first postoperative flatus,and liquid diet was（3.0±0.8）d,and（7.3±2.8）d,respectively.The duration of postoperative hospital stay was（13.5±11.1）d.The incidence of postoperative complication was 9.1%（9/66）,but no mortality occurred during and in early postoperative period.Conclusion:Delta-shaped gastroduodenostomy is simple,easy,safe,and feasible.It will be an ideal choice for reconstruction for totally laparoscopic distal gastrectomy,and has high value in clinical practice.