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


CONCLUSIONS
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.
Bu
Xian-Min
XM
Department of Hepatobiliary Pancreatic Surgery, 2nd Affiliated Hospital, China Medical University, 36 Sanhao Street, Heping District, Shenyang, Liaoning Province, China. buxianmin@163.com
Xu
Jin
J
Dai
Xian-Wei
XW
Ma
Kai
K
Yang
Fu-Quan
FQ
Hu
Jun
J
Wang
Nai-Fu
NF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy*; D011708:Pylorus / Q000502:physiology*; D012189:Retrospective Studies; D013997:Time Factors