Clinical and surgical factors influencing delayed gastric emptying after pyloric-preserving pancreaticoduodenectomy.
Hepatogastroenterology
; 52(61): 143-8, 2005.
Article
em En
| MEDLINE
| ID: mdl-15783015
ABSTRACT
BACKGROUND/AIMS:
Delayed gastric emptying (DGE) is the most common and troublesome complication after pylorus-preserving pancreaticoduodenectomy (PPPD), however, definitive treatment has not yet been established. We examined the clinical and surgical factors relevant to DGE using multivariate analyses.METHODOLOGY:
Forty-four patients with PPPD were divided into two groups according to reconstructive technique group A (25), Billroth II type with antecolic duodenojejunostomy and group B (19), Billroth-I type. Multiple clinical and surgical factors influencing DGE were evaluated by univariate and multivariate analyses.RESULTS:
The period and output of gastric aspiration were significantly reduced in group A compared with group B (a median of 3 days vs. 14 days and a mean output of 133+26mL vs. 506+80mL, respectively; p<0.0001). Re-insertion of the tube was required in 8% of group A compared with 32% of group B. A liquid or solid diet was started at medians of 8 and 14 days in group A compared with 22 and 28 days in group B (p<0.0001), respectively. Multivariate analyses disclosed that the antecolic duodenojejunostomy and major complication were two exclusive independent predictors of restoration of gastric motility.CONCLUSIONS:
Occurrence of DGE was strongly affected by reconstruction technique and major complication. Billroth II reconstruction with antecolic duodenojejunostomy seems to be a useful technique to minimize the occurrence of DGE.
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pancreaticoduodenectomia
/
Gastroparesia
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Hepatogastroenterology
Ano de publicação:
2005
Tipo de documento:
Article
País de afiliação:
Japão