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AIM To search for a new surgical method which accords with physiologico-anatomical principles, reducethe incidence rate of some postoperative complications in conventional Billroth I (CB1) gastrectomy andraise the life quality of patients after surgery.METHODS Using the blood vessels and innervation of the remaining stomach and duodenum, we designeda new pyloric sphincter reconstruction (PSR) in Billroth I gastrectomy, in which the end of the duodenumremnant is surrounded by the seromuscular valve of 2 cm wide in the end of the greater curvature, thickenedthe muscle of the stoma and reconstructed a similar pylorus with the sphincteric function.RESULTS Eleven patients were treated, 8 males and 3 females, 6 malignant and 5 benign and 1accompanied by mould infection, aged from 33 to 73 years, with 1 to 29 years of gastric disease history(average 7.9 years). The function of gastric emptying was shown to be essentially normal by barium mealstudy with video record one month after the operation. The pyloric-like control effect was present in thereconstructive pylorus. PSR vs CB1 vs NES (P >0.01); PSR vs CB1 (P < 0.01); PSR vs NSE (P >0.05).CONCLUSION The new method of pyloric reconstruction is safer, simpler and more effective thanconventional procedures. This method can be applied to all patients for whom Billroth 1 anastomosis can beperformed regardless of benign or malignant lesion.
