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uncut Roux en Y gastrojejunostomy (uncut RY-GJ)

After conventional distal gastrectomy with lymphadenectomy, jejunum of a distal segment from 10 to 20cm from Treitz is used for reconstruction. Jejunal segment is transposed in a way of ante-colon, and then gastrojejunostomy is performed using 60mm linear cutting stapler or hand-sawing technique with absorbable suture. After anastomosis, reinforcement suture is done.

Billroth-II (B-II)

After conventional distal gastrectomy with lymphadenectomy, jejunum is transected in the segment from 10 to 20 cm, and then distal end is transposed in a way of retro-colon to perform anastomosis using 60mm linear cutting stapler or hand-sawing technique with absorbable suture. After anastomosis, reinforcement suture is done. The resected proximal jejunum and the portion of jejunum distal 45 cm from gastrojejunostomy are anastomosed using 60mm linear cutting stapler or hand-sawing technique with absorbable suture followed by reinforcement suture.

Roux en Y gastrojejunostomy (RY-GJ)

After conventional distal gastrectomy with lymphadenectomy, jejunum of distal segment 45 cm from Treitz ligament is used for reconstruction. Jejunal segment is transposed in a way of ante-colon, and then gastrojejunostomy is performed using 60mm linear cutting stapler or hand-sawing technique with absorbable suture followed by reinforcement suture. After anastomosis, afferent loop distal 5cm is obstructed using non-cutting stapler or hand sawing suture. And then, distal jejunum 10 cm from obstructive portion and efferent jejunal loop distal 45 cm from gastrojejunostomy are anastomosed in a manner of side to side followed by reinforcement suture.

uncut Roux en Y gastrojejunostomy

Wook Kim, MD, PhD

The purpose of this study is to evaluate the degree of bile reflux and gastric stasis according the reconstruction methods after distal subtotal gastrectomy for gastric cancer, and to find out the proper method. We collect ninety patients who undergo distal gastrectomy for gastric cancers for this study from 5 institutions and randomly divide into 3 groups according to reconstruction methods: 1) Billroth-II (B-II), 2) Roux en Y gastrojejunostomy (RY-GJ) and 3) uncut Roux en Y gastrojejunostomy (uncut RY-GJ).

Patients who have undergone gastrectomy for gastric cancer might be developed various symptoms by gastric stasis and bile reflux, it so called "post-gastrectomy syndrome", because of the diminishment of stomach capacity, the decrease of expulsive ability and the change of food passage. Until now, that had been accepted as the inevitable results after gastric resection. However, the survival rate has recently been increased owing to the increased proportion of early gastric cancer. And thus, to improve the quality of life of patients, many researchers have been actually studying for the reconstruction methods which are able to minimize the symptom by gastrectomy, but it is dissatisfied until now. Thus, the purpose of this study is to evaluate the degree of bile reflux and gastric stasis according the reconstruction methods after distal subtotal gastrectomy for gastric cancer, and to find out the proper method.

We collect ninety patients who undergo distal gastrectomy for gastric cancers for this study from 5 institutions and randomly divide into 3 groups according to reconstruction methods: 1) Billroth-II (B-II), 2) Roux en Y gastrojejunostomy (RY-GJ) and 3) uncut Roux en Y gastrojejunostomy (uncut RY-GJ). We evaluate the postoperative morbidity rate and then the degree of bile reflux, gastric emptying time and quality of life through long term follow-up using the gastrofiberscope, survey and so on.

From this study, we would suggest the standard reconstruction procedure after distal gastrectomy.

Comparison Study for Bile Reflux and Gastric Stasis in Patients After Distal Gastrectomy

Phase III Study on Comparison for Bile Reflux and Gastric Stasis in Patients With Gastric Cancer After Distal Gastrectomy

The Catholic University of Korea

Wook Kim

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization
Comparison Study for Bile Reflux and Gastric Stasis in Patients After Distal Gastrectomy	NCT00622804	Stomach Cancer Gastrectomy	Billroth-II (B-... Roux en Y gastr... uncut Roux en Y...	20 Years - 75 Years	The Catholic University of Korea
Comparison Study for Bile Reflux and Gastric Stasis in Patients After Distal Gastrectomy	NCT00622804	Stomach Cancer Gastrectomy	Billroth-II (B-... Roux en Y gastr... uncut Roux en Y...	20 Years - 75 Years	The Catholic University of Korea
Comparison Study for Bile Reflux and Gastric Stasis in Patients After Distal Gastrectomy	NCT00622804	Stomach Cancer Gastrectomy	Billroth-II (B-... Roux en Y gastr... uncut Roux en Y...	20 Years - 75 Years	The Catholic University of Korea
Comparison Study for Bile Reflux and Gastric Stasis in Patients After Distal Gastrectomy	NCT00622804	Stomach Cancer Gastrectomy	Billroth-II (B-... Roux en Y gastr... uncut Roux en Y...	20 Years - 75 Years	The Catholic University of Korea

Spots Global Cancer Trial Database for postgastrectomy syndrome