Introducere: Tratamentul cancerului gastric este gastrectomia radicala: distala (GD), proximala (GP) sau totala (GT) cu limfodisectie D1, D1+, D2 cu sau fara tratament chimioterapic neoadjuvant, in dependenta de stadiul maladiei. In baza ghidului japonez pentru tratamentul cancerului gastric (editia 6-a, 2021), unde sunt elucidate metodele de reconstructie dupa gastrectomie, am decis sa implementam metoda de reconstructie ”double tract” si ”interpozitia jejunala” în clinica noastra. Obiectiv: implementarea metodei ”double tract” si ”interpozitia jejunala” de reconstructie dupa tratament chirugical radical in tumorile gastrice pentru imbunatatirea calitatii vietii pacientilor. Material și metode: Studiul a fost efectuat pe parcursul 2021-2023. Lotul de cercetare de 31 pacienti. Rezultate: Operatii cu recostructie ”double tract”: gastrectomie distala – 7; gastrectomie proximala – 9; gastrectomie totala – 12; cu ”interpozitie jejunala”: gastrectomie totala – 3. Complicatii postoperatorii (conform clasificarii ClavienDindo): tip I - 12 cazuri, tip II – 7, IIIb – 1, tip IVa – 1, tip V – 2. Concluzii: 1. Procedeu simplu. 2. Pastrarea pasajului duodenal. 3. Absenta bontului duodenal care elimina riscul de dehiscenta postoperatorie. 4. Permite investigarea edoscopica la necesitate a tubului digestiv superior in perioada postoperatorie imediata in caz de hemoragie/dehiscenta a anastomozelor. 5. Ofera posibilitatea unei papilosfincterotomii in caz de pancreatita acuta post-operatorie sau coledocolitiaza. 6. Previne deficitul de vitamina B12. 7. Nu creste riscul de stricturi anastomotice. 8. Micsoreaza incidenta esofagitei de reflux.

Introduction: The treatment of gastric cancer is radical gastrectomy: distal (DG), proximal (PG) or total (TG) with D1, D1+, D2 lymphodissection with or without neoadjuvant chemotherapy, depending on the stage of the disease. Based on the Japanese guide for the treatment of gastric cancer (6th edition, 2021), where the reconstruction methods after gastrectomy are elucidated, we decided to implement the "double tract" and "jejunal interposition" reconstruction method in our clinic. Objective: implementation of the "double tract" and "jejunal interposition" method of reconstruction after radical surgical treatment in gastric tumors to improve the quality of life of patients. Material and methods: The study was conducted during 2021-2023. The research group consisted of 31 patients. Results: Operations with ""double tract"" reconstruction: distal gastrectomy - 7; proximal gastrectomy – 9; total gastrectomy – 12; with ""jejunal interposition"": total gastrectomy - 3. Postoperative complications (according to the Clavien-Dindo classification): type I - 12 cases, type II - 7, IIIb - 1, type IVa - 1, type V - 2. Conclusions: 1. Simple procedure. 2. Preservation of the duodenal passage. 3. The absence of the duodenal stump, which eliminates the risk of postoperative dehiscence. 4. It allows the edoscopic investigation of the upper digestive tube when necessary in the immediate postoperative period in case of hemorrhage/dehiscence of the anastomoses. 5. It offers the possibility of a papillosphincterotomy in case of acute post-operative pancreatitis or choledocholithiasis. 6. Prevents vitamin B12 deficiency. 7. Does not increase the risk of anastomotic strictures. 8. Reduces the incidence of reflux esophagitis.