The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non-pylorus-preserving pancreaticoduodenectomy.

Abstract

BACKGROUND:

Delayed gastric emptying (DGE) after pancreaticoduodenectomy increases length of hospital stay and costs, and may be influenced by surgical techniques.

METHODS:

We retrospectively compared 400 patients with antecolic gastrojejunostomy with 400 patients with retrocolic gastrojejunostomy for the occurrence of DGE.

RESULTS:

The prevalence of DGE was 15% in the antecolic group and 21% in the retrocolic group (P = .021), and median length of stay was shorter for the former (8 vs. 10 days, P = .001). The difference was statistically significant with grade A DGE (9% vs. 14%, P = .038), but not B or C. In a multivariate analysis, DGE was influenced by retrocolic reconstruction, as well as older age, chronic pancreatitis, preoperative bilirubin level, a history of previous upper abdominal surgery, and postoperative pancreatic fistula.

CONCLUSIONS:

An antecolic gastrojejunostomy for classic non-pylorus-preserving pancreaticoduodenectomy is associated with a lower incidence of mild DGE (grade A) and a shorter length of stay.

• Authors: Klaus Sahora, Vicente Morales-Oyarvide, Sarah P Thayer, Christina R Ferrone, Andrew L Warshaw, Keith D Lillemoe, Carlos Fernández-Del Castillo
• Journal: American journal of surgery (Am J Surg) Vol. 209 Issue 6 Pg. 1028-35 (Jun 2015) ISSN: 1879-1883 [Electronic] United States
• PMID: 25124295 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2015 Elsevier Inc. All rights reserved.

Topics

• Adult
• Aged
• Aged, 80 and over
• Female
• Gastroenterostomy (methods)
• Gastroparesis (epidemiology, etiology, prevention & control)
• Humans
• Incidence
• Length of Stay
• Male
• Middle Aged
• Multivariate Analysis
• Pancreaticoduodenectomy (methods)
• Postoperative Complications (epidemiology, prevention & control)
• Retrospective Studies
• Treatment Outcome