Effects of antecolic versus retrocolic reconstruction for gastro/duodenojejunostomy on delayed gastric emptying after pancreatoduodenectomy
EAES Academy. Motelchuk S. 07/05/22; 363077; P122
Dr. Serhii Motelchuk
Contributions
Contributions
Abstract
Purpose. To evaluate the influence of known methods of forming digestive anastomoses on the occurrence of delayed gastric emptying (DGE) after рancreaticoduodenectomy (PD).
Materials and methods. Postoperative complications occurred in 43 (42%) after PD (Table 1). Pancreaticoduodenectomy was performed in 102 patients according to standard methods. 50 (49%) patients underwent pyloric-preserving рancreaticoduodenectomy (PPPD), of which 13 (50%) were diagnosed with DGE, 52 (50%) patients underwent by the method of Whipple, of whom 10 (38%) were diagnosed with DGE
Results:
Pancreaticoduodenectomy was performed in 102 patients. PPPD with antecolic manual duodenojejunostomy in 50 (49%) patients; PD with antecolic manual gastrojejunostomy in 48 (47%), with retrocolic manual gastrojejunostomy in 4 (4%). The average time of PPPD is 390 - (230-600) minutes, PD - 406 (255-760) minutes. The volume of intraoperative blood loss in PPPD was 367 (200-600) ml, PD - 436 (200-1200) ml. The time of postoperative stay of the patient in the hospital is 30 (15-80) days after PPPD and 24 (6-42) days after pancreaticoduodenectomy without pylorus preservation. Slowing of delayed gastric emptying was diagnosed in 26 (25,5%).
Conclusions:
Preservation of the pylorus during pancreaticoduodenectomy contributes to a higher level of slowing of gastric emptying than during resection of the pylorus. Duodenojejunostomy formed using stapled in pylorus-preserving pancreaticoduodenectomy given the small sample size of patients, it is difficult to assess the effect on the rate of slowing of gastric emptying in retrocolic or antecolic digestive anastomosis, and stapled anastomosis versus hand-sewn anastomosis. Further development and evaluation of methodologies are needed.
Materials and methods. Postoperative complications occurred in 43 (42%) after PD (Table 1). Pancreaticoduodenectomy was performed in 102 patients according to standard methods. 50 (49%) patients underwent pyloric-preserving рancreaticoduodenectomy (PPPD), of which 13 (50%) were diagnosed with DGE, 52 (50%) patients underwent by the method of Whipple, of whom 10 (38%) were diagnosed with DGE
Results:
Pancreaticoduodenectomy was performed in 102 patients. PPPD with antecolic manual duodenojejunostomy in 50 (49%) patients; PD with antecolic manual gastrojejunostomy in 48 (47%), with retrocolic manual gastrojejunostomy in 4 (4%). The average time of PPPD is 390 - (230-600) minutes, PD - 406 (255-760) minutes. The volume of intraoperative blood loss in PPPD was 367 (200-600) ml, PD - 436 (200-1200) ml. The time of postoperative stay of the patient in the hospital is 30 (15-80) days after PPPD and 24 (6-42) days after pancreaticoduodenectomy without pylorus preservation. Slowing of delayed gastric emptying was diagnosed in 26 (25,5%).
Conclusions:
Preservation of the pylorus during pancreaticoduodenectomy contributes to a higher level of slowing of gastric emptying than during resection of the pylorus. Duodenojejunostomy formed using stapled in pylorus-preserving pancreaticoduodenectomy given the small sample size of patients, it is difficult to assess the effect on the rate of slowing of gastric emptying in retrocolic or antecolic digestive anastomosis, and stapled anastomosis versus hand-sewn anastomosis. Further development and evaluation of methodologies are needed.
Purpose. To evaluate the influence of known methods of forming digestive anastomoses on the occurrence of delayed gastric emptying (DGE) after рancreaticoduodenectomy (PD).
Materials and methods. Postoperative complications occurred in 43 (42%) after PD (Table 1). Pancreaticoduodenectomy was performed in 102 patients according to standard methods. 50 (49%) patients underwent pyloric-preserving рancreaticoduodenectomy (PPPD), of which 13 (50%) were diagnosed with DGE, 52 (50%) patients underwent by the method of Whipple, of whom 10 (38%) were diagnosed with DGE
Results:
Pancreaticoduodenectomy was performed in 102 patients. PPPD with antecolic manual duodenojejunostomy in 50 (49%) patients; PD with antecolic manual gastrojejunostomy in 48 (47%), with retrocolic manual gastrojejunostomy in 4 (4%). The average time of PPPD is 390 - (230-600) minutes, PD - 406 (255-760) minutes. The volume of intraoperative blood loss in PPPD was 367 (200-600) ml, PD - 436 (200-1200) ml. The time of postoperative stay of the patient in the hospital is 30 (15-80) days after PPPD and 24 (6-42) days after pancreaticoduodenectomy without pylorus preservation. Slowing of delayed gastric emptying was diagnosed in 26 (25,5%).
Conclusions:
Preservation of the pylorus during pancreaticoduodenectomy contributes to a higher level of slowing of gastric emptying than during resection of the pylorus. Duodenojejunostomy formed using stapled in pylorus-preserving pancreaticoduodenectomy given the small sample size of patients, it is difficult to assess the effect on the rate of slowing of gastric emptying in retrocolic or antecolic digestive anastomosis, and stapled anastomosis versus hand-sewn anastomosis. Further development and evaluation of methodologies are needed.
Materials and methods. Postoperative complications occurred in 43 (42%) after PD (Table 1). Pancreaticoduodenectomy was performed in 102 patients according to standard methods. 50 (49%) patients underwent pyloric-preserving рancreaticoduodenectomy (PPPD), of which 13 (50%) were diagnosed with DGE, 52 (50%) patients underwent by the method of Whipple, of whom 10 (38%) were diagnosed with DGE
Results:
Pancreaticoduodenectomy was performed in 102 patients. PPPD with antecolic manual duodenojejunostomy in 50 (49%) patients; PD with antecolic manual gastrojejunostomy in 48 (47%), with retrocolic manual gastrojejunostomy in 4 (4%). The average time of PPPD is 390 - (230-600) minutes, PD - 406 (255-760) minutes. The volume of intraoperative blood loss in PPPD was 367 (200-600) ml, PD - 436 (200-1200) ml. The time of postoperative stay of the patient in the hospital is 30 (15-80) days after PPPD and 24 (6-42) days after pancreaticoduodenectomy without pylorus preservation. Slowing of delayed gastric emptying was diagnosed in 26 (25,5%).
Conclusions:
Preservation of the pylorus during pancreaticoduodenectomy contributes to a higher level of slowing of gastric emptying than during resection of the pylorus. Duodenojejunostomy formed using stapled in pylorus-preserving pancreaticoduodenectomy given the small sample size of patients, it is difficult to assess the effect on the rate of slowing of gastric emptying in retrocolic or antecolic digestive anastomosis, and stapled anastomosis versus hand-sewn anastomosis. Further development and evaluation of methodologies are needed.
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