title: Method of pyloric reconstruction and impact upon delayed gastric emptying and hospital stay after pylorus-preserving pancreaticoduodenectomy.
abstract: 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.
authors.affiliation: Department of Surgery, The Methodist Hospital, Weill Medical College of Cornell University, Houston, TX 77030, USA. Craig.P.Fischer@tmh.tmc.edu
authors.forename: Craig P
authors.initials: CP
authors.lastname: Fischer
authors.forename: Johnny C
authors.initials: JC
authors.lastname: Hong
mesh_terms: 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