Delayed gastric emptying following pancreatoduodenectomy with alimentary reconstruction according to Roux-en-Y or Billroth-II

BMC Surgery

Research Article

Volker Schmitz¹  Markus Webler²  Jens Standop³  Steffen Manekeller⁴  Tim R. Glowka⁴  Hanno Matthaei⁴  Nico Schäfer⁴  Jörg C. Kalff⁴ 

[1] Department of Gastroenterology, St. Marienwörth Hospital, Mühlenstr. 39, 55543, Bad Kreuznach, Germany;Department of Orthopedic and Trauma Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany;Department of Surgery, Maria Stern Hospital, Am Anger 1, 53424, Remagen, Germany;Department of Surgery, University of Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany;

关键词: Delayed gastric emptying;    DGE;    Pancreatoduodenectomy;    Billroth II;    Whipple;    Roux-en-Y;   

DOI  :  10.1186/s12893-017-0226-x

 received in 2016-10-27, accepted in 2017-03-16,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDelayed gastric emptying (DGE) remains the most frequent complication following pancreatoduodenectomy (PD) with published incidences as high as 61%. The present study investigates the impact of bowel reconstruction techniques on DGE following classic PD (Whipple-Kausch procedure) with pancreatogastrostomy (PG).MethodsWe included 168 consecutive patients who underwent PD with PG with either Billroth II type (BII, n = 78) or Roux-en-Y type reconstruction (ReY, n = 90) between 2004 and 2015. Excluded were patients with conventional single loop reconstruction after pylorus preserving procedures. DGE was classified according to the 2007 International Study Group of Pancreatic Surgery definition. Patients were analyzed regarding severity of DGE, morbidity and mortality, length of hospital stay and demographic factors.ResultsNo difference was observed between BII and ReY regarding frequency of DGE. Overall rate for clinically relevant DGE was 30% (ReY) and 26% (BII). BII and ReY did not differ in terms of demographics, morbidity or mortality. DGE significantly prolongs ICU (four vs. two days) and hospital stay (20.5 vs. 14.5 days). Risk factors for DGE development are advanced age, retrocolic reconstruction, postoperative hemorrhage and major complications.ConclusionsThe occurrence of DGE can not be influenced by the type of alimentary reconstruction (ReY vs. BII) following classic PD with PG. Old age and major complications could be identified as important risk factors in multivariate analysis.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00011860. Registered 14 March 2017.

【 授权许可】

CC BY   
© The Author(s). 2017