Current status of intracorporeal gastroduodenostomy and modified delta-shape anastomosis after distal gastrectomy for gastric cancer

Since Kanaya et al. reported intracorporeal Billroth I (delta-shaped) anastomosis (1), it has been widely accepted for laparoscopic distal gastrectomy. This reconstruction method has several advantages such as small incision and less pain compared to extracorporeal anastomosis. The postoperative nutritional outcomes were similar (2). Besides delta-shape anastomosis, several other intracorporeal Billroth I anastomosis methods were introduced such as ‘triangulating stapling technique’’, “intracorporeal handsewn Billroth-I anastomosis”, and “linear-shaped gastroduodenostomy” (3-5). In linear-shaped gastroduodenostomy, complicated rotation of the duodenum was not required. Vascular supply to the anastomosis was not compromised as the anterior-superior border of duodenum and greater curvature of stomach lie perpendicular to the transection stapler line.