The DOLFIN method: a novel laparoscopic Billroth-I gastroduodenostomy for gastric cancer with duodenal invasion

Autor: Naoki Shinno, Takeshi Omori, Hisashi Hara, Masaaki Yamamoto, Kohei Fujita, Takashi Kanemura, Tomohira Takeoka, Takahito Sugase, Masayoshi Yasui, Chu Matsuda, Hiroshi Wada, Junichi Nishimura, Naotsugu Haraguchi, Hirofumi Akita, Shinichiro Hasegawa, Nozomu Nakai, Kei Asukai, Yousuke Mukai, Hiroshi Miyata, Masayuki Ohue, Masato Sakon
Rok vydání: 2022
Předmět:
Zdroj: Langenbeck's Archives of Surgery. 407:3147-3152
ISSN: 1435-2451
Popis: Laparoscopic Billroth-I gastroduodenostomy using a delta-shaped anastomosis is safe and feasible. However, it is often difficult to perform in patients who have a short posterior wall of the duodenum. Thus, we have developed a new method named duodenal overlap functional anastomosis with linear stapler (DOLFIN). We hereby report the technical details of the new method and our preliminary experience performing it.After the completion of lymphadenectomy, the duodenum was transected craniocaudally with an endoscopic linear stapler. The hepatoduodenal mesentery was dissected approximately 4 cm along the duodenal bulb, and the anastomosis between the posterior wall of the stomach and the lesser curvature of the duodenum was created. The common entry hole was then transected using an endoscopic linear stapler, and the anastomosis was finally completed.There were 36 patients with gastric cancer who underwent laparoscopic distal gastrectomy (LDG) or robotic distal gastrectomy (RDG) with B-I reconstruction using DOLFIN. There were no postoperative complications classified as C-D grade 3 or more and complications related to anastomosis, such as anastomotic leak or stenosis.Our DOLFIN gastroduodenostomy can be performed safely. In addition, it results in good postoperative outcomes. A long-term comparative study is required to further evaluate the clinical usefulness of this method.
Databáze: OpenAIRE