ORIGINAL RESEARCH article
Front. Surg.
Sec. Surgical Oncology
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1635611
This article is part of the Research TopicSurgical Management and Outcomes for Gastric CancerView all 6 articles
Intracorporeal Circular-Stapled Gastroduodenostomy for Billroth I Reconstruction in Total Laparoscopic Distal Gastrectomy
Provisionally accepted
- Yancheng First People's Hospital, Yancheng, China
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Objectives: While laparoscopic distal gastrectomy (LDG) has gained acceptance for early gastric cancer, challenges persist in intracorporeal circular-stapled gastroduodenostomy during totally laparoscopic distal gastrectomy (TLDG). This study introduces a novel technique using a laparoscopic purse-string suture clamp (Lap-PSC) and multifunctional sealing cap (MSC) to simplify Billroth I circular-stapled anastomosis.: A single-center retrospective analysis was conducted on 47 gastric cancer patients undergoing TLDG with Lap-PSC and MSC between September 2022 and June 2024. Surgical procedures involved D2 lymph node dissection, a 5 cm upper abdominal incision for specimen extraction, and intracorporeal circular-stapled anastomosis using Lap-PSC for duodenal purse-string suturing and MSC for pneumoperitoneum maintenance. Postoperative outcomes, complications, and anastomotic integrity were evaluated. Results: All 47 patients underwent successful TLDG with negative resection margins. Mean operative time was 148.3 ± 41.4 minutes. One patient (2.1%) experienced postoperative gastroparesis, and one patient (2.1%) experienced postoperative pneumonia. No anastomotic leaks, strictures, or perioperative deaths occurred. Median follow-up was 21.4 months (range: 13 -34), with no recurrence or anastomosis-related complications. Conclusion: TLDG with Circular-Stapled Gastroduodenostomy for Billroth I anastomosis demonstrates technical feasibility and safety, combining the precision of open surgery with laparoscopic minimally invasive benefits. The technique simplifies intracorporeal circular-stapled anastomosis, avoids excessive tension, and may reduce ischemic risks associated with linear stapler methods.
Keywords: Total Laparoscopic Distal Gastrectomy (TLDG), Circular-Stapled Gastroduodenostomy, Purse-String Suture Clamp(PSC), Multi-Functional Seal Cap(MSC), gastric cancer
Received: 26 May 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Jiang, yang, Zhou, zhuang, sun and ding. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Haohai Jiang, Yancheng First People's Hospital, Yancheng, China
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