Delayed gastric emptying after pylorus preserving pancreaticoduodenectomy—does gastrointestinal reconstruction technique matter?

Meta-analysis of delayed gastric emptying after pylorus-preserving versus pylorus-resecting pancreatoduodenectomy

“…Regarding further differences in reconstruction techniques, sensitivity analyses showed that the method of duodenoenteric or gastroenteric reconstruction (antecolic versus retrocolic) and pancreaticojejunostomy versus pancreaticogastrostomy did not affect the results substantially. This is in line with current data from well performed studies 4,32,33 . With regard to perioperative and postoperative management, Fujii and co-workers 23 reported that oral intake was started routinely on postoperative day 7, which is very late and not according to today's standard 34 .…”

Impact of delayed gastric emptying after pancreaticoduodenectomy on survival

“…Regarding PPPD, in a randomized controlled trial, Tani et al reported that antecolic reconstruction for DJ during PPPD decreased the incidence of DGE compared with retrocolic reconstruction . Similar results were reported in retrospective studies and a recent meta‐analysis . Among the patients who underwent PPPD in the present study, the incidence of DGE in the antecolic group was 45%.…”

Retrocolic versus antecolic gastrointestinal reconstruction in robotic pancreaticoduodenectomy

“…Interestingly, although several reports have mentioned the differences in antecolic and retrocolic methods for GJ anastomosis, very few studies focused on the exact location of the retrocolic route . Furthermore, in nearly all studies, open surgery was performed . Nevertheless, in the current study, we clearly defined the location of the L‐port and the results revealed that using the L‐port technique may significantly decrease the incidence of postoperative DGE.…”