Anastomotic stricture of Billroth-I gastroduodenostomy using a hemi-double stapling technique

Although the hemi-double stapling (HDS) technique is one of the methods of mechanically stapled anastomosis for Billroth-I (B-I) gastroduodenostomy, the development of anastomotic strictures has not been discussed adequately. Thus, we performed a retrospective study to compare the anastomotic stricture of the HDS and the hand-sutured anastomosis (HSA) technique.

We selected 74 early gastric cancer patients in whom B-I reconstruction was performed under laparotomy after distal gastrectomy. The patients were divided into 2 groups: HDS (34 patients) and HSA (40 patients). Several parameters such as time required for achieving anastomosis, operative blood loss, the rate of anastomotic stricture formation, time to resumption of oral intake, and postoperative complications were examined.

There was no difference between the 2 groups with regard to operative blood loss, time to resumption of oral intake, and postoperative complications. The time required for the operation and for achieving anastomosis was shorter in the HDS group than in the HSA group. The rate of anastomotic stricture formation was not significantly different between the 2 groups, but was lower in the HDS group than in the HSA group.

We conclude that the HDS technique reduces the duration of operation and the rate of anastomotic stricture formation.