Prevention of Delayed Gastric Emptying After Pylorus-Preserving Pancreatoduodenectomy with Antecolic Reconstruction, a Long Jejunal Loop, and a Jejuno-Jejunostomy

Cordesmeyer, Stefanie; Lodde, S.; Zeden, K.; Kabar, Iyad; Hoffmann, Matthias

doi:10.1007/s11605-013-2446-4

Cited by 22 publications

(29 citation statements)

References 41 publications

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“…Eleven eligible studies were determined through applying our inclusion criteria. 3 , 13 , 14 , 17 – 24 Two of 11 were reported by the same institute and the same first author. 20 , 24 Only 1 with more detailed data was selected 20 to avoid statistical bias because of duplicate counting (Figure 1 ).…”

Section: Resultsmentioning

confidence: 97%

Braun Enteroenterostomy Following Pancreaticoduodenectomy

Zhu

Qian

et al. 2015

Medicine

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Section: Resultsmentioning

confidence: 97%

Braun Enteroenterostomy Following Pancreaticoduodenectomy

Zhu

Qian

et al. 2015

Medicine

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“…The Braun jejunojejunostomy is thought to be an important procedure for reducing the risk of DGE [12, 33]. Because the Braun jejunojejunostomy can reduce the pressure in the biliopancreatic limb, it may decrease stimulation to the pressure receptors of the gastrointestinal tract, thereby decreasing the incidence of DGE.…”

Section: Discussionmentioning

confidence: 99%

“…The possible factors associated with DGE include antroduodenal ischemia [35], postoperative intra-abdominal complications [1, 5, 6, 27, 36, 37], low plasma motilin concentration [3, 38], and technical factors such as torsion or angulation of the digestive tract reconstruction [32, 33, 39]. Among the several possible factors of DGE, the most important are postoperative intra-abdominal complications like pancreatic fistula, biliary fistula, and intra-abdominal abscess [35, 36].…”

Section: Discussionmentioning

confidence: 99%

Superiority of stapled side-to-side gastrojejunostomy over conventional hand-sewn end-to-side gastrojejunostomy for reducing the risk of primary delayed gastric emptying after subtotal stomach-preserving pancreaticoduodenectomy

et al. 2017

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Background and purposeDelayed gastric emptying (DGE) is the most common complication following pancreaticoduodenectomy (PD). The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD.MethodsThe subjects of this retrospective study were 137 patients who underwent pancreaticoduodenectomy, as subtotal stomach-preserving pancreaticoduodenectomy (SSPPD; n = 130), or conventional whipple procedure (n = 7) with Child reconstruction, between January 2010 and May 2014. The patients were divided into two groups according to whether they had had a stapled side-to-side anastomosis (SA group; n = 57) or a conventional hand-sewn end-to-side anastomosis (HA group; n = 80).ResultsSA reduced the operative time (SA vs. HA: 508 vs. 557 min, p = 0.028) and the incidence of delayed gastric emptying (SA vs. HA: 21.1 vs. 46.3%, p = 0.003) and was associated with shorter hospitalization (SA vs. HA: 33 vs. 39.5 days, p = 0.007). In this cohort, SA was the only significant factor contributing to a reduction in the incidence of DGE (p = 0.002).ConclusionsStapled side-to-side gastrojejunostomy reduced the operative time and the incidence of DGE following PD with Child reconstruction, thereby also reducing the length of hospitalization.

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“…Meanwhile, we found that the gastrin G-17 level was significantly increased compared to that before the surgery instead of being decreased, and its mechanisms were still not clear. G-17 has important roles in gastrointestinal hormones [17], and this also demonstrated the necessity of retaining the gastric antrum.…”

Section: Discussionmentioning

confidence: 99%

Phase I Clinical Research of Jejunal Interposition in Adenocarcinoma of the Esophagogastric Junction II/III Proximal Gastrectomy

Tao

Dong

2016

Gastroenterology Research and Practice

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Objective. To investigate the feasibility and specific methods of single-tract jejunal interposition between esophagus and remnant stomach (ers-STJI) in adenocarcinoma of the esophagogastric junction (AEG) II/III proximal gastrectomy. Methods. 15 AEG II/III gastric cancer (GC) patients in phase T1-3N0M0 with tumor size <5 cm were selected and they underwent proximal gastrectomy with ers-STJI from August 2013 to August 2014. Results. All of the 15 patients successfully completed GC R0 proximal gastrectomy with ers-STJI and no operative death or no significant complication occurred; one patient had anastomotic inflammatory granuloma. The digestive tract reconstruction time was 29.5 ± 5.7 min; the intraoperative blood loss was 96.7 ± 20.2 mL, and the number of lymph node dissections was 21.3 ± 3.0; the postoperative flatus time was 48.2 ± 11.9 h; the average length of hospital stay was 10.7 ± 2.3 d, and the average hospital stay cost was 60 ± 3 thousands. All of the patients were followed up for 12 months, and their postoperative single food intake, body weight, hemoglobin, and albumin were all recovered to the preoperative levels. Conclusions. The applications of ers-STJI in proximal gastrectomy were safe and feasible, and the length of jejunal interposition could be 15–25 cm.

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Prevention of Delayed Gastric Emptying After Pylorus-Preserving Pancreatoduodenectomy with Antecolic Reconstruction, a Long Jejunal Loop, and a Jejuno-Jejunostomy

Abstract: The results of this retrospective study suggest that the antecolic route with a long jejunal loop and Braun's anastomosis minimizes DGE rates.

Cited by 22 publications

References 41 publications

Braun Enteroenterostomy Following Pancreaticoduodenectomy

Braun Enteroenterostomy Following Pancreaticoduodenectomy

Superiority of stapled side-to-side gastrojejunostomy over conventional hand-sewn end-to-side gastrojejunostomy for reducing the risk of primary delayed gastric emptying after subtotal stomach-preserving pancreaticoduodenectomy

Phase I Clinical Research of Jejunal Interposition in Adenocarcinoma of the Esophagogastric Junction II/III Proximal Gastrectomy

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