Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction

IF 1.4 Q3 SURGERY Surgery open science Pub Date : 2024-10-31 DOI:10.1016/j.sopen.2024.10.005

Felix O. Hofmann , Victoria S. Engelstädter , Ughur Aghamaliyev , Mathilda M. Knoblauch , Elise Pretzsch , Maximilian Weniger , Jan G. D'Haese , Bernhard W. Renz , Jens Werner , Matthias Ilmer

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Abstract

Background

After pylorus-resecting pancreatoduodenectomy (PrPD), delayed gastric emptying (DGE) might partially be attributed to biliary reflux. We investigated whether the incidence of primary DGE is reduced after Roux-en-Y instead of Billroth-II reconstruction.

Methods

Patients undergoing PrPD from 2016 to 2019 at a high-volume center were identified. Excluding causes of secondary DGE, we matched patients with Roux-en-Y and Billroth-II reconstruction in a 1:2 ratio and compared primary DGE.

Results

In 24 vs. 48 (Roux-en-Y vs. Billroth-II) patients, DGE (grade B/C) incidence (20.8 % vs. 18.8 %; P = 1.000), nasogastric tube requirement (median 2 vs. 2 days; P = 0.844) and time to solid food intake (7 vs. 7 days; P = 0.933) were comparable. Univariable logistic regression showed no association between DGE and Roux-en-Y reconstruction (OR 1.47; P = 0.524), in contrast to age (1.08; P = 0.030) and pancreatic biochemical leak (4.98; P = 0.007).

Conclusions

Primary DGE did not differ between Roux-en-Y and Billroth-II reconstruction after PrPD. Instead, age and postoperative pancreatic biochemical leak were associated with higher DGE risk.

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幽门切除胰十二指肠术后原发性胃排空延迟：Roux-en-Y重建与Billroth-II重建的配对比较

背景幽门切除胰十二指肠切除术（PrPD）后，胃排空延迟（DGE）可能部分归因于胆汁反流。我们研究了 Roux-en-Y 代替 Billroth-II 重建后是否会降低原发性 DGE 的发生率。结果在24例与48例（Roux-en-Y与Billroth-II）患者中，DGE（B/C级）发生率（20.8% vs. 18.8%；P = 1.000）、鼻胃管需求（中位2天 vs. 2天；P = 0.844）和固体食物摄入时间（7天 vs. 7天；P = 0.933）相当。单变量逻辑回归显示，DGE与Roux-en-Y重建（OR 1.47；P = 0.524）之间没有关联，而与年龄（1.08；P = 0.030）和胰腺生化漏（4.98；P = 0.007）之间有关联。相反，年龄和术后胰腺生化漏与较高的 DGE 风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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