{"title":"Impact of route of reconstruction of gastrojejunostomy on delayed gastric emptying after pancreaticoduodenectomy: A prospective randomized study.","authors":"Lokesh Arora, Vutukuru Venkatarami Reddy, Sivarama Krishna Gavini, Chandramaliteeswaran Chandrakasan","doi":"10.14701/ahbps.22-123","DOIUrl":null,"url":null,"abstract":"<p><strong>Backgrounds/aims: </strong>Pancreaticoduodenectomy (PD) is commonly performed pancreatic procedure for tumors of periampullary region. Delayed gastric emptying (DGE) and pancreatic fistula are the most common specific complications following PD. DGE can lead to significant morbidity, resulting in prolonged hospital stay and increased cost. Various factors might influence the occurrence of DGE. We hypothesized that kinking of jejunal limb could be a cause of DGE post PD.</p><p><strong>Methods: </strong>Antecolic (AC) and retrocolic (RC) side-to-side gastrojejunostomy (GJ) groups in classical PD were compared for the occurrence of DGE in a prospective study. All patients who underwent PD between April 2019 and September 2020 in a tertiary care center in south India were included in this study.</p><p><strong>Results: </strong>After classic PD, RC GJ was found to be superior to AC in terms of DGE rate (26.7% vs. 71.9%) and hospital stay (9 days vs. 11 days).</p><p><strong>Conclusions: </strong>Route of reconstruction of GJ can influence the occurrence of DGE as RC anastomosis in classical PD provides the most straight route for gastric emptying.</p>","PeriodicalId":72220,"journal":{"name":"Annals of hepato-biliary-pancreatic surgery","volume":"27 3","pages":"287-291"},"PeriodicalIF":1.1000,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/41/ahbps-27-3-287.PMC10472118.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of hepato-biliary-pancreatic surgery","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.14701/ahbps.22-123","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Backgrounds/aims: Pancreaticoduodenectomy (PD) is commonly performed pancreatic procedure for tumors of periampullary region. Delayed gastric emptying (DGE) and pancreatic fistula are the most common specific complications following PD. DGE can lead to significant morbidity, resulting in prolonged hospital stay and increased cost. Various factors might influence the occurrence of DGE. We hypothesized that kinking of jejunal limb could be a cause of DGE post PD.
Methods: Antecolic (AC) and retrocolic (RC) side-to-side gastrojejunostomy (GJ) groups in classical PD were compared for the occurrence of DGE in a prospective study. All patients who underwent PD between April 2019 and September 2020 in a tertiary care center in south India were included in this study.
Results: After classic PD, RC GJ was found to be superior to AC in terms of DGE rate (26.7% vs. 71.9%) and hospital stay (9 days vs. 11 days).
Conclusions: Route of reconstruction of GJ can influence the occurrence of DGE as RC anastomosis in classical PD provides the most straight route for gastric emptying.
背景/目的:胰十二指肠切除术(PD)是治疗壶腹周围肿瘤的常用胰腺手术。胃排空延迟和胰瘘是PD后最常见的特异性并发症。DGE可导致显著的发病率，导致住院时间延长和费用增加。多种因素可能影响DGE的发生。我们假设空肠肢体扭结可能是PD后DGE的一个原因。方法:前瞻性研究比较经典PD患者侧结肠(AC)组和后结肠(RC)组胃空肠造口术(GJ)组DGE的发生情况。2019年4月至2020年9月期间在印度南部三级医疗中心接受PD治疗的所有患者都被纳入了这项研究。结果:经典PD后，RC GJ在DGE率(26.7% vs. 71.9%)和住院时间(9天vs. 11天)方面优于AC。结论:GJ重建路径影响胃排空的发生，经典PD的RC吻合为胃排空提供了最直接的路径。
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