Duan XX, Yu X, Gan J. Analysis of quality of life and reflux oesophagitis following Billroth II and Roux-en-Y gastrointestinal reconstruction for gastric cancer. World J Gastrointest Surg 2026; 18(1): 114164 [DOI: 10.4240/wjgs.v18.i1.114164]
Corresponding Author of This Article
Jin Gan, MD, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, No. 48 Taling South Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. gj19863419@163.com
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Gastroenterology & Hepatology
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Duan XX, Yu X, Gan J. Analysis of quality of life and reflux oesophagitis following Billroth II and Roux-en-Y gastrointestinal reconstruction for gastric cancer. World J Gastrointest Surg 2026; 18(1): 114164 [DOI: 10.4240/wjgs.v18.i1.114164]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114164 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114164
Analysis of quality of life and reflux oesophagitis following Billroth II and Roux-en-Y gastrointestinal reconstruction for gastric cancer
Xin-Xing Duan, Xiong Yu, Jin Gan
Xin-Xing Duan, Xiong Yu, Jin Gan, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, Jiujiang 332000, Jiangxi Province, China
Author contributions: Duan XX designed the study, conducted data collection and analysis, and drafted the initial manuscript; Yu X participated in data verification and provided critical input on manuscript content refinement; Gan J supervised the entire research process, formulated key research directions, revised the manuscript for intellectual content, coordinated peer review responses, and ensured the integrity of the work. All authors have read and approved the final manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital.
Informed consent statement: All the individuals who participated in this study provided their written informed consent prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflicts of interest.
Data sharing statement: No additional data are available.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin Gan, MD, General Surgery Center, Jiujiang City Key Laboratory of Cell Therapy, Jiujiang No. 1 People's Hospital, No. 48 Taling South Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. gj19863419@163.com
Received: September 15, 2025 Revised: October 9, 2025 Accepted: November 18, 2025 Published online: January 27, 2026 Processing time: 131 Days and 0.8 Hours
Abstract
BACKGROUND
The choice between Billroth II and Roux-en-Y reconstruction after radical gastrectomy for gastric cancer (GC) affects the occurrence of reflux and the quality of life (QoL) in patients.
AIM
To investigate the QoL and reflux oesophagitis incidence in patients who underwent Billroth II or Roux-en-Y gastrointestinal reconstruction after radical gastrectomy for GC.
METHODS
One hundred patients with GC who underwent radical resection at our hospital between January 2023 and December 2024 were enrolled. The patients were divided into two groups based on the postoperative gastrointestinal reconstruction technique: The Billroth II group and the Roux-en-Y group, comprising 50 patients each. The incidence of gastroesophageal reflux within two weeks postoperatively was compared between the groups, including 24-hour reflux episodes, frequency of reflux episodes lasting > 5 minutes, and maximum reflux duration. The reflux symptom scores were measured. Nutritional indicators, including serum albumin (ALB), prealbumin (PA), and haemoglobin (Hb), were assessed 4 and 8 weeks postoperatively. The QoL was evaluated using the QLQ-C30 questionnaire. The incidence of reflux oesophagitis was monitored at 3 months of follow-up.
RESULTS
No significant differences were observed between the groups in terms of baseline clinical characteristics (P > 0.05). At 2 weeks postoperatively, the Roux-en-Y group exhibited significantly lower 24-hour reflux episodes, episodes lasting > 5 minutes, and maximum reflux duration than the Billroth II group (P < 0.05). The Roux-en-Y group exhibited significantly lower reflux symptom scores, including epigastric burning, acid regurgitation, upper abdominal distension, and upper abdominal pain, than the Billroth II group (P < 0.05). No significant differences were observed in the peripheral blood ALB, PA, or Hb levels at 4 and 8 weeks postoperatively between the two groups (P > 0.05). The QLQ-C30 scores at 4 and 8 weeks postoperatively were significantly higher in the Roux-en-Y group than in the Billroth II group (P < 0.05). At the 3-month postoperative follow-up, the incidence of reflux oesophagitis was 4.0% in the Roux-en-Y group, significantly lower than the 16.0% observed in the Billroth II group (P < 0.05).
CONCLUSION
Among patients with GC undergoing gastrointestinal reconstruction, Roux-en-Y procedures resulted in fewer cases of gastroesophageal reflux and milder symptoms than Billroth II procedures. Nutritional status was comparable postoperatively between the two reconstruction techniques. However, the former significantly affects the patients' QoL less favourably and exhibits a lower incidence of reflux oesophagitis, demonstrating considerable clinical significance.
Core Tip: This study demonstrates that compared to Billroth II reconstruction, Roux-en-Y anastomosis significantly reduces the incidence of gastroesophageal reflux and reflux esophagitis, alleviates reflux-related symptoms, and improves postoperative quality of life (QoL) in gastric cancer patients after radical distal gastrectomy. Although operative time may be longer with Roux-en-Y, it offers superior long-term functional outcomes by minimizing bile reflux and associated complications, without compromising nutritional status. Roux-en-Y reconstruction is recommended for its enhanced QoL benefits and reduced reflux morbidity.
