Reduction of alkaline reflux gastritis and marginal ulcer by modified Braun enteroenterostomy in gastroenterologic reconstruction after pancreaticoduodenectomy

Braun Enteroenterostomy Following Pancreaticoduodenectomy

“… 20 , 24 Only 1 with more detailed data was selected 20 to avoid statistical bias because of duplicate counting (Figure 1 ). Therefore, 10 studies regarding 1614 patients were included for our meta-analysis: 3 , 13 , 14 , 17 – 23 6 in China, 3 , 13 , 19 , 20 , 22 , 23 1 in USA, 18 1 in Australia, 21 1 in German, 17 and 1 in Japan. 14 The sample size of BEE following PD ranged from 21 to 347.…”

Braun enteroenterostomy reduces delayed gastric emptying: A systematic review and meta-analysis

“…It was reported that BEE not only decreased the occurrence of ARG and MU [19], but also reduced the pressure of the biliopancreatic limb, contributing to a lower incidence of pancreatic fistula [20]. However, In Hochwald's [12] study, one patient who underwent a BEE presented with a perforation at the GJ 12 months after PD, and they speculated that the development of MU was associated with the accumulation of gastric acid which was not neutralized by alkaline bile in the jejunum near the GJ.…”

“…It is worth mentioning that few researchers had made some changes of this surgical procedure. In Wang's report [19], an enteroenterostomy was performed proximal to the gastroenterostomy, and the ambilateral jejunum were anastomosed using a 75-mm linear cutter stapler. Interestingly, this kind of modified BEE showed significant advantages over NonBraun group in terms of ARG and related sequela, while no significant differences exist between the two groups in terms of DGE (28.1% BEE vs 20% Non-Braun, P ¼ 0.455).…”

“…Pooled analysis revealed no significant difference in the rate of pancreatic fistula (7 studies [10,12,13,18e21]: OR, 0.70; 95%CI, 0.35 to 1.40; P ¼ 0.31; I 2 ¼ 69%), bile leakage (6 studies [10,12,18e21]: OR, 0.61; 95%CI, 0.34 to 1.08; P ¼ 0.09; I 2 ¼ 0%) and intra-abdominal abscess (5 studies [10,12,18,19,21]: OR, 0.92; 95%CI, 0.58 to 1.45; P ¼ 0.71; I 2 ¼ 0%) between Braun group and Non-Braun group.…”

Effects of adding Braun jejunojejunostomy to standard Whipple procedure on reduction of afferent loop syndrome — a randomized clinical trial

“…[7][8][9] Vogel and colleagues 7 reported that postoperative complications, including enterogastric reflux and biliary reflux, were significantly less frequent in patients undergoing Braun jejunojejunostomy than in those undergoing any types of gastrojejunostomy without adding Braun jejunojejunostomy. Another study reported that adding Braun jejunojejunostomy after gastroenterostomy in patients with biliary reflux significantly reduced the reflux.…”