Impact of Straight Stomach Reconstruction on Delayed Gastric Emptying and Nutritional Recovery After Pancreaticoduodenectomy.

Naoki Iwanaga, Yuzuru Ito, S. Miyano, Michio Machida, Ikuo Watanobe, H. Sugo
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Abstract

BACKGROUND The aim of this study was to evaluate the effectiveness of a modified reconstruction technique-anchored straight stomach reconstruction-in reducing the incidence of delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) and its impact on postoperative nutritional recovery. METHODS A case series analysis of 125 consecutive PD patients was conducted: 104 of them had undergone anchored straight stomach reconstruction (SSR group) and the remaining 21 without (Non-SSR group). The incidence of DGE and the change in postoperative nutritional status (body weight and serum albumin level during 12 months post-surgery) were compared. RESULTS The incidence of DGE in the SSR group (13%) was significantly lower than that in the Non-SSR group (33%) (P = .018); further the significant DGE (grade B or C) was only 5%. Comparison of nutritional status showed that SSR facilitated a prompt recovery of body weight and serum albumin level at 6 months after PD. At 12 months after surgery, body weight gain was significantly better in the SSR group than in the Non-SSR group (P = .006), and albumin level tended to be higher in the SSR group (P = .071). CONCLUSION Straight stomach reconstruction is able to reduce DGE in patients after PD and also improves their postoperative nutritional recovery.
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直胃重建对胰十二指肠切除术后延迟胃排空和营养恢复的影响
背景本研究旨在评估一种改良的重建技术--锚定直胃重建--在降低胰十二指肠切除术(PD)后延迟胃排空(DGE)发生率方面的效果及其对术后营养恢复的影响。方法对125例连续PD患者进行了病例系列分析:其中104例接受了锚定直胃重建(SSR组),其余21例未接受(非SSR组)。结果SSR组的DGE发生率(13%)明显低于非SSR组(33%)(P = .018);此外,明显的DGE(B级或C级)仅为5%。营养状况比较显示,在腹膜透析术后 6 个月,SSR 有助于迅速恢复体重和血清白蛋白水平。术后 12 个月时,SSR 组的体重增加情况明显优于非 SSR 组(P = .006),SSR 组的白蛋白水平往往更高(P = .071)。
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