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01-05-2012 | Original Article

Delayed gastric emptying improved by straight stomach reconstruction with twisted anastomosis to the jejunum after pylorus-preserving pancreaticoduodenectomy (PPPD) in 118 consecutive patients at a single institution

Authors: Toshihiko Masui, Ryuchiro Doi, Yoshiya Kawaguchi, Shinji Uemoto

Published in: Surgery Today | Issue 5/2012

Abstract

Purpose

Delayed gastric emptying (DGE) is a leading cause of complication after pylorus-preserving pancreaticoduodenectomy (PPPD). Its incidence has been reported to range from 5 to 57%. We describe a modified reconstruction method, which resulted in a low rate of DGE.

Methods

Between April 2003 and March 2008, we performed PPPD and reconstruction using an antecolic method in 118 consecutive patients. After PPPD, reconstruction was done using conventional Child procedure in 12 patients (PPPD group) and with the following modifications in the remaining 106 patients (PPPDR group): duodenojejunostomy was performed using the straight method and the jejunum was anastomosed with a 30° counterclockwise twist. We evaluated the incidence of DGE based on the grading system defined by the International Study Group of Pancreatic Surgery (ISGPS).

Results

The PPPDR group had a lower incidence of DGE than the PPPD group (PPPD), occurring in 7 patients (7%) versus 4 patients (33%), respectively. However, the overall morbidity rates and postoperative hospital stays of the two groups did not differ significantly.

Conclusions

Straight stomach reconstruction with a twisted anastomosis could reduce the incidence of DGE after PPPD reconstruction.

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Title: Delayed gastric emptying improved by straight stomach reconstruction with twisted anastomosis to the jejunum after pylorus-preserving pancreaticoduodenectomy (PPPD) in 118 consecutive patients at a single institution
Authors: Toshihiko Masui
Ryuchiro Doi
Yoshiya Kawaguchi
Shinji Uemoto
Publication date: 01-05-2012
Publisher: Springer Japan
Published in: Surgery Today / Issue 5/2012
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-011-0097-1

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Delayed gastric emptying improved by straight stomach reconstruction with twisted anastomosis to the jejunum after pylorus-preserving pancreaticoduodenectomy (PPPD) in 118 consecutive patients at a single institution

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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