BACKGROUND: Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). METHODS: The clinical data of 253 patients who had undergone PD were examined. Of a total of 188 patients who had undergone SSPPD, a gastrojejunostomy (GJ) was performed with end-to-side anastomosis in 87 patients (SSPPD-ETS group), and a GJ was performed with a greater curvature side-to-jejunal side anastomosis in 101 patients (SSPPD-STS group). After propensity score matching, the matched cohort consisted of 74 patients in each group. The postoperative data were evaluated according to the International Study Group of Pancreatic Surgery grade of DGE. RESULTS: The total incidence of DGE was 9.4% in the SSPPD-ETS group and 4% in the SSPPD-STS group, with no significant difference (p = 0.1902). A significant difference was observed between the two groups in the incidence of DGE grade C (p = 0.0426). CONCLUSIONS: The incidence of total DGE was not reduced statistically in the STS group compared with the ETS group, but reduced DGE grade C. Side-to-side anastomosis might be associated with a reduced incidence of DGE grade C.
BACKGROUND: Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD). METHODS: The clinical data of 253 patients who had undergone PD were examined. Of a total of 188 patients who had undergone SSPPD, a gastrojejunostomy (GJ) was performed with end-to-side anastomosis in 87 patients (SSPPD-ETS group), and a GJ was performed with a greater curvature side-to-jejunal side anastomosis in 101 patients (SSPPD-STS group). After propensity score matching, the matched cohort consisted of 74 patients in each group. The postoperative data were evaluated according to the International Study Group of Pancreatic Surgery grade of DGE. RESULTS: The total incidence of DGE was 9.4% in the SSPPD-ETS group and 4% in the SSPPD-STS group, with no significant difference (p = 0.1902). A significant difference was observed between the two groups in the incidence of DGE grade C (p = 0.0426). CONCLUSIONS: The incidence of total DGE was not reduced statistically in the STS group compared with the ETS group, but reduced DGE grade C. Side-to-side anastomosis might be associated with a reduced incidence of DGE grade C.
Authors: Thilo Hackert; Ulf Hinz; Werner Hartwig; Oliver Strobel; Stefan Fritz; Lutz Schneider; Jens Werner; Markus W Büchler Journal: Am J Surg Date: 2013-06-24 Impact factor: 2.565
Authors: Steven N Hochwald; Stephen R Grobmyer; Alan W Hemming; Eleanor Curran; David A Bloom; Matthew Delano; Kevin E Behrns; Edward M Copeland; Stephen B Vogel Journal: J Surg Oncol Date: 2010-04-01 Impact factor: 3.454
Authors: A Floortje van Oosten; Ding Ding; Joseph R Habib; Ahmer Irfan; Ryan K Schmocker; Elisabetta Sereni; Benedict Kinny-Köster; Michael Wright; Vincent P Groot; I Quintus Molenaar; John L Cameron; Martin Makary; Richard A Burkhart; William R Burns; Christopher L Wolfgang; Jin He Journal: J Gastrointest Surg Date: 2020-11-17 Impact factor: 3.452
Authors: Jae Pil Jung; Mazen S Zenati; Mashaal Dhir; Amer H Zureikat; Herbert J Zeh; Richard L Simmons; Melissa E Hogg Journal: JAMA Surg Date: 2018-10-01 Impact factor: 14.766