Uncut Roux-en-Y significantly reduces bile reflux and enhances quality of life post-distal gastrectomy for gastric cancer.

• Bile reflux incidence at 3 months: uncut R-Y (6.8%) vs. Billroth-II (77.6%) and Billroth II Braun (63.6%), p < 0.001.
• Results held at 12 months: 10.5% for uncut R-Y compared to 86% for Billroth-II and 67.9% for Billroth II Braun, p < 0.001.

Consider adopting uncut R-Y as the preferred reconstruction method to improve long-term patient outcomes.

• Longer operation time for uncut R-Y, but no short-term differences in complications across the groups.