Long-term postoperative functional evaluation of pylorus preservation in Imanaga pancreatoduodenectomy.
Our purpose was to determine whether pylorus-preservation in the Imanaga (PpPDI) method minimizes postoperative impairment of gastrointestinal function. Nine patients who had undergone PpPDI (postoperative years: 5.7 +/- 2.6) and nine patients who had undergone conventional Imanaga pancreatoduodenectomy (PDI) (postoperative years: 6.8 +/- 2.0) were evaluated for symptoms, nutritional parameters, and physiologic function of the biliary tract and residual stomach using gastric emptying and hepatobiliary scintigraphy. The body weight recovered to 99.3% +/- 3.8% of pre-illness body weight in PpPDI, showing a significantly better recovery than in patients after the PDI procedure (91.0% +/- 6.4%, P < 0.05). The mean gastric emptying half-time (GET1/2) in the upright position after PDI was significantly shorter (42.3 min) than after PpPDI (80.8 min, P < 0.05). Mixture of food with bile was conserved better in the PpPDI group than in the PDI group. In the long term, the pylorus-preserving Imanaga-type procedure minimizes disruption of gastric function and asynchrony between ingested food and bile.
Sato
T
T
Department of Surgery, Toyama Prefectural Central Hospital, Japan.
Konishi
K
K
Yabushita
K
K
Kimura
H
H
Maeda
K
K
Tsuji
M
M
Kinuya
K
K
Nakajima
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000601:surgery*; D001835:Body Weight / Q000502:physiology; D003138:Common Bile Duct Neoplasms / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D016473:Gallbladder Emptying / Q000502:physiology; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000503:physiopathology*; D011706:Pyloric Antrum / Q000503:physiopathology*