Billroth II reconstruction in gastric cancer surgery: A good option for Western patients

Am J Surg. 2019 Nov;218(5):940-945. doi: 10.1016/j.amjsurg.2019.03.009. Epub 2019 Mar 13.

Abstract

Purpose: The aim of this study is to report the short and long-term results of a cohort of patients who underwent Billroth II (BII) Distal Gastrectomy (DG) for gastric cancer (GC), in a tertiary referral Western center.

Methods: From January 2005 to December 2015, a prospective observational study was conducted in candidate patients to elective gastrectomy for cancer.

Results: Among 514 patients observed with GC, a series of 258 patients underwent BII DG for middle/lower third GC. Postoperative mortality and complication rates were 1.5% and 12.4% respectively. The overall and disease-free 5-year survival rates were 78% and 69%, respectively. Young age, lymph nodes retrieved, radicality of resection, and early tumor stages were independent positive prognostic factors at multivariate analysis for 5-year overall survival. Abdominal complications and advanced tumor stages negatively influenced 5-year disease-free survival at multivariate analysis.

Conclusion: BII provides excellent results in terms of short and long-term prognosis and should be regarded as an acceptable reconstructive option following DG for GC.

Keywords: Billroth II reconstruction; Distal gastrectomy; Gastric cancer.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Combined Modality Therapy
  • Female
  • Gastrectomy
  • Gastroenterostomy* / adverse effects
  • Gastroenterostomy* / mortality
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Stomach / surgery*
  • Stomach Neoplasms / surgery*
  • Stomach Neoplasms / therapy
  • Treatment Outcome