Is delayed gastric emptying so terrible after pylorus-preserving pancreaticoduodenectomy? Prevention and management

doi:10.3748/wjg.v12.i39.6382

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Oct 21, 2006 (publication date) through Nov 24, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Oct 21, 2006; 12(39): 6382-6385
Published online Oct 21, 2006. doi: 10.3748/wjg.v12.i39.6382

Is delayed gastric emptying so terrible after pylorus-preserving pancreaticoduodenectomy? Prevention and management

Xian-Min Bu, Jin Xu, Xian-Wei Dai, Kai Ma, Fu-Quan Yang, Jun Hu, Nai-Fu Wang

Xian-Min Bu, Jin Xu, Xian-Wei Dai, Kai Ma, Fu-Quan Yang, Department of Hepatobiliary Pancreatic Surgery, 2nd Affiliated Hospital, China Medical University, Shenyang, Liaoning Province, China

Jun Hu, Nai-Fu Wang, Department of general surgery, Panjin hospital of traditional Chinese medicine, Panjin, Liaoning Province, China

Correspondence to: Dr Xian-Min Bu, Department of Hepatobi-liary Pancreatic Surgery, 2nd Affiliated Hospital, China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning Province, China. buxianmin@163.com

Telephone: +86-24-83956512 Fax: +86-24-23892617

Received: June 19, 2006
Revised: June 28, 2006
Accepted: July 18, 2006
Published online: October 21, 2006

Abstract

AIM: To explore some operative techniques to prevent the occurrence of delayed gastric emptying (DGE) after pylorus-preserving pancreaticoduodenectomy (PPPD).

METHODS: One hundred and eighty-six patients in a single medical center who accepted PPPD were retrospectively studied. The incidence of DGE was investigated and the influence of some operative techniques on the prevention of DGE was analyzed.

RESULTS: During the operative process of PPPD, the methods of detached drainage of pancreatic fluid and bile and gastric fistulization were used. Postoperatively, six patients suffered DGE among the 186 cases; the incidence was 3.23% (6/186). One of them was complicated with intraabdominal infection at the same time, and two with pancreatic leakage.

CONCLUSION: Appropriate maneuvers during operation are essential to avoid postoperative DGE in PPPD. The occurrence of DGE is avoidable. It should not be used as an argument to advocate hemigastrectomy in PPPD.

Keywords: Delayed gastric emptying; Pylorus-preserving pancreaticoduodenectomy; Gastric fistulization