Comparison of Billroth II with Braun and Roux-en-Y reconstructions after distal gastrectomy for gastric cancer: A meta-analysis

Roux-en-Y (RY) and Billroth II with Braun (BB) reconstruction are two similar methods of reconstruction after distal gastrectomy (DG). Currently, it is unclear which method is superior. This meta-analysis was performed to compare the safety and efficacy of BB and RY reconstruction after DG for gastric cancer. A literature search of Pubmed, Embase, Web of Science, and Cochrane Library was conducted to identify studies comparing BB with RY after DG for gastric cancer until the end of October 2022. Main outcomes assessed were perioperative outcomes, postoperative complications, functional findings, and nutritional status. Meta-analyses were performed using RevMan 5.4 software. Finally, eight studies with a total of 910 patients were considered for the meta-analysis. The meta-analysis results revealed that operation time, anastomosis time, incidence of total complications, and delayed gastric emptying were reduced, and the incidence of bile reflux was increased in patients undergoing BB compared to RY reconstruction. In conclusion, BB has the advantage of reducing operative time, anastomotic time, intraoperative blood loss, overall postoperative complications, and delayed gastric emptying. RY has the advantage of preventing bile reflux and gastritis after surgery.