**3. Roux-en-Y reconstruction (RY)**

Roux-en-Y reconstruction is one of the standard options after distal gastrectomy. In 1995, Kitano et al. used an extracorporeal gastrojejunostomy with manual suturing as a reconstruction procedure for distal gastrectomy. The improvements in stapling devices contributed to easy access to the site of operation. The advantage and disadvantage of RY reconstruction compared with Billroth I are as follows: prevention of bile reflex and reduction in incidence of anastomotic leakage.
