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World Journal of Surgery
Published in: World Journal of Surgery 6/2021

01-06-2021 | Gastrectomy | Original Scientific Report

Surgical Outcome of Pancreaticoduodenectomy in Patients with a History of Roux-en-Y Reconstruction after Tumor Removal

Authors: Daiki Marukawa, Yoshito Tomimaru, Shogo Kobayashi, Yoshifumi Iwagami, Daisaku Yamada, Hirofumi Akita, Takehiro Noda, Kunihito Gotoh, Yuichiro Doki, Hidetoshi Eguchi

Published in: World Journal of Surgery | Issue 6/2021

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Abstract

Background

The need for pancreaticoduodenectomy (PD) after Roux-en-Y (RY) reconstruction after tumor removal is expected to increase in future, but current studies on outcome are sparse. This surgery is challenging, due to intraabdominal adhesions and/or anatomical changes introduced by the previous abdominal surgery. Here, we investigated the surgical outcomes of PD after RY reconstruction following tumor removal.

Methods

We enrolled 283 patients that underwent PD. Surgical outcomes for PD were compared between patients with or without a history of RY reconstruction after tumor removal. Outcomes were also compared between two different surgical procedures for the post-PD reconstruction.

Results

Among 283 patients, 11 had a history of RY reconstruction after tumor removal (3.9%). Among these, RY reconstructions had been performed where the small intestine was anastomosed to a remnant stomach after distal gastrectomy (n = 2), to remnant stomach after proximal gastrectomy (n = 1), to the esophagus after total gastrectomy (n = 6), or to the hepatic duct after extrahepatic bile duct resection (n = 2). Surgical outcomes were not significantly different between cases with and without RY reconstructions. We identified two different reconstruction procedures after removing the periampullary tumor during PD. The surgical outcomes were not significantly different between these two reconstruction groups.

Conclusions

The surgical outcome of PD was not significantly affected by a history of RY reconstruction. Similarly, the type of reconstruction performed during PD did not significantly affect the outcome. These results could be useful when planning PD in patients with a history of RY reconstruction after tumor removal.
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Metadata
Title
Surgical Outcome of Pancreaticoduodenectomy in Patients with a History of Roux-en-Y Reconstruction after Tumor Removal
Authors
Daiki Marukawa
Yoshito Tomimaru
Shogo Kobayashi
Yoshifumi Iwagami
Daisaku Yamada
Hirofumi Akita
Takehiro Noda
Kunihito Gotoh
Yuichiro Doki
Hidetoshi Eguchi
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2021
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-021-05998-5

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