Clinical Research Directory

Inclusion Criteria: * Age from 18 to years (including 18 and 85years old) * Pathological diagnosis of primary focus is gastric adenocarcinoma made by endoscopic biopsy (papillary, tubular, mucinous, signet ring cell, poorly differentiated) * cT1-4a, N+/-, M0 at preoperative evaluation * No peritoneal metastasis or other distant metastases of gastric carcinoma (affirmed by laparoscopic surgery and related imaging examinations) * Expected curative resection through laparoscopic distal gastrectomy with D2 lymphadenectomy (include multiple primary lower gastric adenocarcinoma) * Performance status of 0 or 1 on Eastern Cooperative Oncology Group scale (ECOG) * Preoperative American Society of Anesthesiology score (ASA) classⅠ, Ⅱ or Ⅲ * Major organs are functioning normally: blood routine test (No blood transfusions in the last 14 days): HB≥90g/L, ANC≥1.5×109/L, PLT≥80×109/L blood biochemical examination: BIL\<1.5× upper limit of normal (ULN), ALT and AST\<2.5×ULN, Crea≤1×ULN. \- The subject is willing to participate in this clinical trail Exclusion Criteria: * History of previous upper abdominal surgery (include ESD/EMR, except laparoscopic cholecystectomy) * History of acute pancreatitis * Regional fusion of enlarged lymph nodes by preoperative imaging (maximum diameter \>3cm) * History of other malignant disease within past five years * History of unstable angina, myocardial infarction, cerebral infraction, or cerebral hemorrhage within past six months * History of continuous systematic corticosteroids therapy within past one month * Requirement of simultaneous surgery for other disease * Emergency surgery due to complication (bleeding, or perforation) caused by gastric cancer * FEV1\<50% of predicted values by pulmonary function test * Women during pregnancy or breast-feeding * Severe mental disorder * Participating in other clinical studies simultaneously * Refusing to sign the informed consent for the study * Peritoneal implant or other distant metastases by intraoperative exploration * Unresectable due to tumor reasons by intraoperative exploration * Distal gastric cancer surgery cannot be performed after intraoperative exploration * Duodenal bulb has been invaded by tumor or gastroduodenostomy cannot be performed due to additional surgical resection cause by positive intraoperative frozen margin