Method of pyloric reconstruction and impact upon delayed gastric emptying and hospital stay after pylorus-preserving pancreaticoduodenectomy.
Preservation of the pylorus at the time of pancreaticoduodenectomy has been associated with equal oncological outcomes when compared to the classical Whipple operation. Multiple studies have demonstrated that pylorus-preserving pancreaticoduodenectomy (PPPD) has equal or superior outcomes regarding quality of life when compared with the traditional Whipple operation, but many studies have suggested a higher incidence of delayed gastric emptying (DGE). DGE prolongs hospital stay, and its association with PPPD has hampered its adoption by many pancreatic surgery centers. We describe a novel surgical technique for the prevention of delayed gastric emptying following pylorus-preserving pancreaticoduodenectomy. The technique of pyloric dilatation appears to decrease the incidence of delayed gastric emptying and facilitates earlier hospital discharge, when compared with standard pylorus preserving pancreaticoduodenectomy.
Fischer
Craig P
CP
Department of Surgery, The Methodist Hospital, Weill Medical College of Cornell University, Houston, TX 77030, USA. Craig.P.Fischer@tmh.tmc.edu
Hong
Johnny C
JC
D018784:Abdominal Abscess / Q000209:etiology; D000368:Aged; D016063:Blood Loss, Surgical; D015331:Cohort Studies; D004106:Dilatation / Q000295:instrumentation / Q000379:methods; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010195:Pancreatitis / Q000601:surgery; D010351:Patient Discharge; D011183:Postoperative Complications; D011446:Prospective Studies; D011708:Pylorus / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012307:Risk Factors; D016896:Treatment Outcome