Safety of modified double-stapling end-to-end gastroduodenostomy in distal subtotal gastrectomy

Background and Objectives Double‐stapling end‐to‐end gastroduodenostomy (DS‐BI) has several potential advantages over other anastomotic techniques in that it is a simple procedure, with no additional gastrotomy on the remnant stomach, and less tension on the anastomosis site. We evaluated the safety of DS‐BI by comparing it with the hand‐sewn Billroth II gastrojejunostomy (B‐II). Methods Medical records of 933 consecutive patients (DS‐BI 428, B‐II 505) who underwent distal subtotal gastrectomy were retrospectively reviewed. Several clinicopathological features and treatment results were compared between the two groups. Results The overall complication rates were 9.3% in the DS‐BI group and 15.2% in the B‐II group (P = 0.007). Anastomosis‐related complications, such as anastomosis‐site leakage, stenosis, and intraluminal bleeding, did not differ between the two groups (1.2% in the DS‐BI group and 1.8% in the B‐II group, P = 0.59). All the anastomosis‐related complications were managed conservatively. Postoperative mortality rates were 0% in the DS‐BI group and 0.4% (2/505) in the B‐II group. Conclusions Modified DS‐BI is a safe procedure, with short‐term results similar to those of hand‐sewn Billroth II anastomosis. J. Surg. Oncol. 2007;96:624–629. © 2007 Wiley‐Liss, Inc.