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Journal of Gastrointestinal Surgery

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01-07-2011 | Original Article

Delayed Gastric Emptying after Pancreaticoduodenectomy: Influence of the Orthotopic Technique of Reconstruction and Intestinal Motilin Receptor Expression

Authors: Otto Kollmar, Jens Sperling, Mohammed Reza Moussavian, Darius Kubulus, Sven Richter, Martin Karl Schilling

Published in: Journal of Gastrointestinal Surgery | Issue 7/2011

Abstract

Background

Delayed gastric emptying (DGE) is still a common postoperative complication after pancreaticoduodenectomy (PD). Because different reconstruction techniques after PD and the influence of motilin receptor expression are controversially discussed, the present study analyzed the influence of a total orthotopic reconstruction technique on DGE after PD.

Methods

Data from patients undergoing PD and reconstruction using a total orthotopic technique were reviewed, and correlations between DGE and clinico-pathological variables were analyzed. Motilin receptor expression was measured within the duodenum, jejunum, and terminal ileum.

Results

Three hundred seven patients received orthotopic reconstruction using a single jejunal loop. DGE grade B or C could be observed in 16.6% of the patients. DGE was significantly associated with the severity of a postoperative pancreatic fistula, the need for a reoperation, wound infections, and vascular complications. Furthermore, these parameters correlated significantly with the grade of DGE. The density of motilin receptor expression decreased significantly behind the duodenum in aboral direction.

Conclusions

The orthotopic reconstruction after PD is the shortest distance without resection of a jejunal segment, preserves the greatest length of jejunum and thus the highest density of motilin receptors, and should therefore be recommended to reduce the incidence of DGE after PD.

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Title: Delayed Gastric Emptying after Pancreaticoduodenectomy: Influence of the Orthotopic Technique of Reconstruction and Intestinal Motilin Receptor Expression
Authors: Otto Kollmar
Jens Sperling
Mohammed Reza Moussavian
Darius Kubulus
Sven Richter
Martin Karl Schilling
Publication date: 01-07-2011
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 7/2011
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-011-1554-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Delayed Gastric Emptying after Pancreaticoduodenectomy: Influence of the Orthotopic Technique of Reconstruction and Intestinal Motilin Receptor Expression

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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