• Journal of Gastric Cancer
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• v.15 no.1
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• pp.46-52
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• 2015

Purpose: The aim of this study was to compare the short-term surgical and long-term functional outcomes of Billroth I, Billroth II, and Roux-en-Y reconstruction after laparoscopic distal gastrectomy. Materials and Methods: We retrospectively collected data from 697 patients who underwent laparoscopic distal gastrectomy for operable gastric cancer between January 2009 and December 2012. The patients were classified into three groups according to the reconstruction methods: Billroth I, Billroth II, and Roux-en-Y. The parameters evaluated included patient and tumor characteristics, operative details, and postoperative complications classified according to the Clavien-Dindo classification. Endoscopic findings of the remnant stomach were evaluated according to the residue, gastritis, bile (RGB) classification and the Los Angeles classification 1 year postoperatively. Results: Billroth I, Billroth II, and Roux-en-Y were performed in 165 (23.7%), 371 (53.2%), and 161 patients (23.1%), respectively. Operation time was significantly shorter ($173.4{\pm}44.7$ minute, P<0.001) as was time to first flatus ($2.8{\pm}0.8$ days, P=0.009), time to first soft diet was significantly faster ($4.3{\pm}1.0$ days, P<0.001), and postoperative hospital stay was significantly shorter ($7.7{\pm}4.0$ days, P=0.004) in Billroth I in comparison to the other methods. Postoperative complications higher than Clavien-Dindo grade III occurred in 61 patients (8.8%) with no statistically significant differences between groups (P=0.797). Endoscopic findings confirmed that gastric residue, gastritis, bile reflux, and reflux esophagitis were significantly lower in Roux-en-Y (P<0.001) patients. Conclusions: Roux-en-Y reconstruction after laparoscopic distal gastrectomy for middle-third gastric cancer is beneficial in terms of long-term functional outcome, whereas Billroth I reconstruction for distal-third gastric cancer has a superior short-term surgical outcome and postoperative weight change.

• Kyungpook Mathematical Journal
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• v.19 no.1
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• pp.3-7
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• 1979

• 대한위암학회:학술대회논문집
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• 2001.11a
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• pp.49-49
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• 2001

• Annals of Hepato-Biliary-Pancreatic Surgery
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• v.28 no.2
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• pp.266-269
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• 2024

Choledochal cyst is a condition involving an abnormal dilation of the bile ducts, which can lead to various symptoms and comorbidities, including cancer. The treatment of choice for choledochal cyst is surgical correction including choledochal cyst excision and Roux-en-y hepaticoenterostomy. Minimal invasive methods like laparoscopic methods or robotic methods are used for surgical correction of choledochal cysts; however, it is still controversial which method is superior. A Korean company, LIVESMED, developed Artisential^®, a laparoscopic surgical instrument that can overcome the drawbacks of laparoscopic methods. This article presents a case of the first Artisential^®-performed surgical excision of a choledochal cyst and hepaticojejunostomy.

• 대한위암학회:학술대회논문집
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• 2005.04a
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• pp.26-26
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• 2005

• Journal of Applied Tourism Food and Beverage Management and Research
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• v.7
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• pp.61-85
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• 1997

1. Background of the Study Old Testament time made some food and Sauces. Cosher food is God's Covernant. Ancient Greek cooking and Roman cooking had been Sauces. Much of what we know of Greek gastronomy is found in the writting of Archestrate, cooking is sigle and direct, Sauces are Cumin, Vinegar, Roman culinary comes from mareus, first century A.D. many of the ingredients used in apicius's recipes are seen againg in midival Eurpean cooking. ① Cumin Sauce for Oyster ② Sauce for grounds, puree, and cardoons. 2. Culinary in the Middle ages Liaquid Flavorings their Sauces tested Verjuice and Vinegar are most often called for when a Liquid is needed, Spices and Liaisons. 3. Cookery the eighteenth century The eighteen the century brought about greated Systemization of basics, coulis, Jus, and bouillons. 4. The twentieth century culinary Careme were Systematized and recorded by Auguste Escoffier in his Guide Culinare Standardized. 5. Grand Sauces are Considered one of the greatest test of a Chef's Skill, Whether they are classics, Such as Sauce, Supreme, demand the highest technical expertise. The Successful paring of Sauce with a good demonstrates an understanding of the food and an ability to judge. Sauce making allows the cook more freedom to work flavors, textures, Aromatics, Tasty, and color than any other area of cooking. A Sauce is never eaten alone, function, balance, the direct flavor, Sauces presents the basic Sauce-making techniques that have been used in the past and that are popular today, Sauces are organized around the primeifhes of classic world cooking 6. Grand Sauces are 1) Brown Sauces are 1) Brown Sauce ① Demiglace ②Espagnole ③ Fond de veau 2) Bechamel Sauce 3) Velote Sauce 4) Tomato Sauce and 5) Hollandaise Sauce ① Brown Sauce made with Stock, Roux, Tomato Paste and Mirepoix. ② Bechamel Sauce made with Roux and Milk. ③ Veloute Sauce made with Roux and White Stock. ④ Tomato Sauce made with Tomto, Vegetable and Stock. ⑤ Hollandaise Sauce made with Egg and Butter.

• Journal of Gastric Cancer
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• v.14 no.4
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• pp.229-237
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• 2014

Purpose: Laparoscopic distal gastrectomy (LDG) is a well-established procedure for the treatment of early gastric cancer. Several reconstruction methods can be adopted after LDG according to tumor characteristics and surgeon preference. This study aimed to compare the remnant gastric functions after different reconstructions. Materials and Methods: In total, 221 patients who underwent LDG between March 2005 and October 2013 were reviewed retrospectively. The patients were classified into four groups based on the reconstructive procedure: Billroth I (BI) anastomosis, Billroth II (BII) with Braun anastomosis, Roux-en-Y (RY) reconstruction, or uncut RY reconstruction. Patient demographics, surgical outcomes, and postoperative endoscopic findings were reviewed and compared among groups. Results: Endoscopic evaluations at $11.8{\pm}3.8$ months postoperatively showed less frequent gastritis and bile reflux in the remnant stomach in the RY group compared to the BI and BII groups. There was no significant difference in the gastric residue among the BI, BII, and RY groups. The incidence of gastritis and bile reflux in the uncut RY group was similar to that in the RY group, while residual gastric content in the uncut RY group was significantly smaller and less frequently observed than that in the RY group (5.8% versus 35.3%, P=0.010). Conclusions: RY and uncut RY reconstructions are equally superior to BI and BII with Braun anastomoses in terms of gastritis and bile reflux in the remnant stomach. Furthermore, uncut RY reconstruction showed improved stasis compared to conventional RY gastrojejunostomy. Uncut RY reconstruction can be a favorable reconstructive procedure after LDG.

• Journal of Gastric Cancer
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• v.17 no.3
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• pp.255-266
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• 2017

Purpose: Although Roux-en-Y (R-Y) reconstruction after distal gastrectomy has several advantages, such as prevention of bile reflux into the remnant stomach, it is rarely used because of the technical difficulty. This prospective randomized clinical trial aimed to show the efficacy of a novel method of R-Y reconstruction involving the use of 2 circular staplers by comparing this novel method to Billroth-I (B-I) reconstruction. Materials and Methods: A total of 118 patients were randomly allocated into the R-Y (59 patients) and B-I reconstruction (59 patients) groups. R-Y anastomosis was performed using two circular staplers and no hand sewing. The primary end-point of this clinical trial was the reflux of bile into the remnant stomach evaluated using endoscopic and histological findings at 6 months after surgery. Results: No significant differences in clinicopathological findings were observed between the 2 groups. Although anastomosis time was significantly longer for the patients of the R-Y group (P<0.001), no difference was detected between the 2 groups in terms of the total surgery duration (P=0.112). Endoscopic findings showed a significant reduction of bile reflux in the remnant stomach in the R-Y group (P<0.001), and the histological findings showed that reflux gastritis was more significant in the B-I group than in the R-Y group (P=0.026). Conclusions: The results of this randomized controlled clinical trial showed that compared with B-I reconstruction, R-Y reconstruction using circular staplers is a safe and feasible procedure. This clinical trial study was registered at www.ClinicalTrials.gov (registration No. NCT01142271).

• Journal of Gastric Cancer
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• v.1 no.4
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• pp.210-214
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• 2001

Purpose: The aim of this study was to evaluate the shortterm outcome of a jejunal interposition, by comparing it with a conventional Roux-en-Y gastrojejunostomy, after a total gastrectomy. Materials and Methods: For 28 patients (20 men and 8 women) with a gastric adenocarcinoma, who underwent an isoperistaltic simple jejunal interposition, weight, hemoglobin, hematocrit, serum protein and albumin, and cholesterol levels were checked before the operation and at 1 year and 2 years after the surgery. Also, endoscopy was performed to confirm reflux esophagitis. In this study, the data were collected between January 1993 and July 1999 at Chungnam National University Hospital, and the results were compared with those of the Roux-en-Y procedure. Results: The body weights at 1 year and 2 years after the surgery had returned to $86.0\%$ and $87.6\%$ of the recent original body weight in the jejunal interposition (JI) group and to $90.8\%,\;87.0\%$, respectively in the Roux-en-Y (RY) group. The levels of hemoglobin (g/dl) were 13.3, 12.5, and 11.9 in the JI group, and 13.8, 12.6, and 12.1 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum protein (g/dl) levels were 7.1, 7.2, and 7.5 in the JI group and 7.1, 7.0, and 7.2 in the RY gropu at the time of the operation and at 1 year and 2 years after the surgery, respectively. The serum albumin (g/dl) levels were 4.2, 4.1, and 4.2 in the JI group and 4.2, 4.2, and 4.2 in the RY group at the time of the operation and at 1 year, and 2 years after the surgery, respectively. The total serum cholesterol (mg/dl) levels were 186.5, 174, and 164 in the JI group and 213.7, 171.1, and 141.0 in the RY group at the time of the operation and at 1 year and 2 years after the surgery, respectively. The endoscopic finding showed that reflux esophagitis occurred in $7.1\%$ of the patients in the JI group and in $3.5\%$ in the RY group. Conclusion: We think that from the view point of quality of life, a jejunal interposition, as well as a Roux-en-Y procedure, is a useful reconstruction methods for a total gastrectomy.

• Applied Biological Chemistry
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• v.42 no.1
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• pp.58-62
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• 1999

Method to access qualities of brown sauce and optimize its cooking conditions was studied by sensory evaluation and response surface methodology. Cooks of an hotel, sauce experts, were selected as sensory panelists, and the brown sauce cooking conditions practically used in an hotel were adopted to prepare sauce samples for the sensory test. The cooking conditions were designed with two factors, i.e., one factor of roux contents with three levels and the other factor of cooking times with three levels, which were known as most important in sauce cooking. Sensory acceptance evaluation with intensity 7 grades was applied for several sauce attributes such as color, flavour, viscosity, taste and overall. Ability of each panel to perceive the differences between the brown sauces prepared under different cooking conditions was judged, and only data of the 9 panelists proved as reliable among the 12 panelists were reflected. The acceptances by different cooking conditions were found to be in the order of 11 > 9 > 13% roux contents and 8 > 9 > 7 hr cooking times. Response surface methodology was treated with second-order model on the sensory data and the optimum cooking conditions with the highest acceptances were $10.3{\sim}10.8%$ roux content and 8 hr cooking time.