New method for Billroth I reconstruction after distal gastrectomy

Authors report a new technique for Billroth I reconstruction after distal gastrectomy using linear stapling devices, which is easier than conventional methods. The duodenum is divided 0.5 cm distal to the pyrolus ring, with a 55-mm linear stapler. The anterior wall of the duodenum is cut along the planned line of anastomosis with the gastric remnant. The anterior wall of the stomach is cut along the planned suture line having a length similar to that of the duodenum. The posterior walls of the stomach and the duodenum are placed back to back on the planned anastomotic line. End-to-end posterior anastomosis between the gastric remnant and the duodenum is simultaneously performed with gastrectomy using a 100-mm linear stapler. End-to-end anterior anastomosis is performed by hand. This technique has been used in 7 patients, and there have been no complications related to this procedure. Operative time was 152 +/- 16 min (range 130 to 180 min) on average. It is an economical and easy procedure for Billroth I reconstruction.