Comparative study of outcomes of Roux-en-Y reconstruction and Billroth I reconstruction performed after radical distal gastrectomy

Summary Background Billroth Ⅰ (B Ⅰ) reconstruction and Roux-en-Y (R Y) reconstruction are both commonly performed after distal gastrectomy (DG). We conducted a retrospective study to evaluate which is the better option. Methods Included in our study were 162 patients who, between April 2011 and October 2015, underwent DG followed by B Ⅰ reconstruction (n = 93) or R Y reconstruction (n = 69). All patients were followed up for at least 1 year. We compared perioperative outcomes, postoperative complications, gastrointestinal (GI) symptoms, endoscopic findings, and nutritional status between the 2 groups of patients. Results Patient characteristics did not differ between the 2 groups, with the exception of the incidence of gastric body tumors, which was significantly higher in the R Y group (73.9% vs. 19.4%; p Y reconstruction group ( p p  = 0.122).The endoscopically determined RGB ( R esidual food, G astritis, B ile reflux)scores were significantly better in the R Y reconstruction group than in the BI reconstruction group ( p  = 0.027, p p p  = 0.484, p  = 0.613, p  = 0.760, p  = 0.890, respectively). Conclusions R Y reconstruction appears not to be advantageous over B Ⅰ reconstruction in terms of GI function or nutritional status 1 year after surgery. R Y reconstruction does appear to be superior in terms of preventing bile reflux but takes more operation time.