Laparoscopic reinforcement suture of duodenal stump using barbed suture during laparoscopic gastrectomy for gastric cancer: preliminary results in consecutive 62 patients

Duodenal stump leakage after gastrectomy is one of serious complications related to severe morbidity or mortality. However, definite surgical method for duodenal stump leakage is not established. Herein, we introduced a new and simple surgical technique to reduce duodenal stump leakage during laparoscopic gastrectomy for gastric cancer. We retrospectively reviewed the medical records for consecutive 62 patients who underwent laparoscopic reinforcement suture (LARS) during laparoscopic gastrectomy for gastric cancer from June 2015 to February 2016 in our institute. After cutting of duodenal stump, LARS commenced with continuous invagination method or interrupted method using barbed suture. Sixty patients underwent distal gastrectomy with B-II, and two patients had total gastrectomy. Mean operation time was 160 minutes, and the mean time for LARS was 8 minutes. Duodenal stump leakage was not observed; however, we observed one case of esophagojejunostomy leakages and one case of artificial lesser curvature leakage. LARS can be performed in a relatively short operation time without any technical difficulties. LARS on staple-line of duodenal stump can be helpful to prevent DSF after laparoscopic gastrectomy for gastric cancer.