Is jejunoduodenostomy anastomosis better than jejunogastrostomy anastomosis in laparoscopic gastrectomyand jejunal interposition?

Abstract

Öz: Introduction: The jejunal interposition can be preferred for reconstruction after laparoscopic gastrectomy because it functions as a reservoir and maintains the connection with the duodenal passage. In this procedure, the jejunal segment can be anastomosed between the proximal stomach and the duodenum or distal stomach. We aimed to present our initial experience with the jejunoduodenostomy and jejunogastrostomy inin jejunal interposition after laparoscopic gastrectomy and the differences between the results of these two anastomoses.Materials and Methods: Six patients who underwent laparoscopic gastrectomy with jejunal interposition between January and August 2020 were investigated. Demographic data and perioperative parameters were analyzed retrospectively. Digestive symptoms following the surgery were assessed by phone call.Results: Five (83.3%) of the total six patients were male. The median age was 70 (range 19–78) years, with a median body mass index (BMI) of 25.8 (range 23–31) kg/m2. The most common surgical indication was gastric adenocarcinoma (n=4). The median operative time was 280 (200–360) minutes, and the median blood loss was 95 (50–100) ml. The median time to oral intake was 3.5 (2–13) days. The median hospital stay was 7.5 (4–16) days. Jejunogastrostomy was performed in three (50%) patients. Postoperative complications occurred in four (66.6%) patients, three of whom were with jejunogastrostomy. The most common postoperative complication was anastomotic leak (n=2).Conclusion: Jejunoduodenostomy is safer than jejunogastrostomy after laparoscopic gastrectomy and jejunal interposition.