Comparison of Clinical Outcomes Between Delta-Shaped and Circular Anastomoses After Laparoscopic Distal Gastrectomy

Asian J Endosc Surg. 2025 Jan-Dec;18(1):e70014. doi: 10.1111/ases.70014.

Abstract

Introduction: Laparoscopic distal gastrectomy (LDG) is the standard treatment for gastric cancer, during which the laparoscopic Billroth I anastomosis technique, also known as the delta-shaped anastomosis (DA), is widely performed. This study aimed to evaluate the differences in short- and long-term symptoms between DA and traditional circular anastomosis (CA) techniques.

Methods: We retrospectively compared DA and CA procedures in patients undergoing LDG and subsequent reconstruction using the Billroth I method at the Kanagawa Cancer Center from 2017 to 2022.

Results: Other than blood loss, no significant differences were observed in the short-term outcomes between the two groups. However, 1-year post-surgery, the DA group had a higher incidence of diarrhea, lower incidence of remnant gastritis, and higher weight loss than the CA group.

Conclusion: Both DA and CA techniques were similar in terms of safety. However, the DA group had a higher incidence of diarrhea and a lower incidence of remnant gastritis than the CA group 1-year after surgery.

Keywords: circular anastomosis; delta‐shaped anastomosis; gastric cancer; laparoscopic distal gastrectomy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Anastomosis, Surgical* / methods
  • Female
  • Gastrectomy* / methods
  • Gastroenterostomy / methods
  • Humans
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Stomach Neoplasms* / surgery
  • Treatment Outcome