PD06.05. Billroth II With Braun Anastomosis Versus Roux-En-YReconstruction Following Distal Gastrectomy: ASystematic Review and Meta-Analysis

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ID: 326050
2026
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Abstract
Abstract Topic Benign Disease: Gastro-Esophageal Reflux and Hiatal Hernia Background The efficacy of Billroth II with Braun (BIIB) anastomosis in laparoscopic distal gastrectomy remains uncertain.We aimed to perform a systematic review and meta-analysis comparing BIIB with Roux en Y (RY) for distal gastrectomy. Methods We systematically searched PubMed, Embase, and Cochrane for studies comparing BIIB versus RY in adult patients undergoing distal gastrectomy. We computed risk ratios (RRs) for binary outcomes and mean differences (MDs) for continuous outcomes, with 95% confidence intervals (CIs). Heterogeneity was assessed with I2 statistics. Statistical analyses were performed using R software. Results We included 10 studies, comprising a total of 1377 patients. BIIB was associated with a lower anastomotic time (MD7.82 min; 95% CI −11.99 to −3.65; p = 0.0002; I2 = 99%), intraoperative blood loss (MD −17.88 mL; 95% CI −31.00 to −4.76;p = 0.0076; I2 = 91%), and operative time (MD −21.67 min; 95% CI −28.62 to −14.72; p < 0.01; I2 = 80%). Also, BIIB group was associated with a higher incidence of bile reflux when compared to the RY group (RR 3.10; 95% CI 1.75 to 5.50; p < 0.0001;I2 = 74%). There were no significant differences between BIIB and RY for anastomotic leakage rate, number of retrieved lymph nodes, gastritis, residual food, time to first exhaust, length of hospital stay, time to liquid diet, and adverse events. Conclusion In adult patients undergoing distal gastrectomy, BIIB was associated with a shorter operative, anastomotic time,and intraoperative blood loss, with an increased incidence of bile reflux. BIIB may be an easier and feasible alternative to RY,especially in patients who should avoid excessive exposure to anesthesia.
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Authors Wendy Chang
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Journal diseases of the esophagus : official journal of the international society for diseases of the esophagus
Year 2026
DOI
10.1093/dote/doag077.117
URL
https://doi.org/10.1093/dote/doag077.117
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