Background: The use of totally laparoscopic surgery with Billroth-I reconstruction (delta-shaped anastomosis) has rapidly become widespread in recent years. However, we experienced delayed gastric emptying (DGE) in the early period after introduction of this technique. To the best of our knowledge, there are no report mentioned the incision line to prevent DGE in distal gastrectomy. In the present study, we standardized the surgical techniques, including the gastric incision line and compared the short-term results before and after standardization. Methods: A total of 86 patients were enrolled in this study. 28 procedures were performed in the early period and 58 procedures were performed in the late period, and the 2 groups were compared retrospectively. Results: The operation time decreased significantly after standardization from 288 min to 224 min (P < 0.001). The median value of perioperative bleeding volume reduced from 22.5 mL to 12.5 mL (P =0.060). There were no postoperative complications related to the site of anastomosis in either group. 5 cases of DGE (17.8%) was noted in the early period, but only 2 cases (3.4%) in the late period (P =0.022). Conclusions: Standardization of the incision line after laparoscopic gastrectomy resulted in a decline in incidence of DGE.

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