title: Pylorotomy in pylorus-preserving pancreaticoduodenectomy.
abstract: OBJECTIVE
  The incidence of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy has been reported to be 30% to 70%.
  
  
  METHODS
  Between January 1996 and December 2002, 43 patients underwent pylorus-preserving pancreaticoduodenectomy, involving pylorotomy, in the First Department of Surgery, Kinki University School of Medicine. The first step in pylorotomy is to cut the duodenal stump obliquely. The next is incision of the pyloric sphincter along its inferior aspect. The incidences of postoperative complications and changes in body weight were collated retrospectively.
  
  
  RESULTS
  Delayed gastric emptying was observed in 4 patients (9.3%). However, this complication did not last more than 1 month in any patients. Two patients (4.7%) developed reflux esophagitis 1 month after surgery, but this complication had resolved by 6 months. Weight gain was noted beginning 3 months after surgery.
  
  
  CONCLUSIONS
  Pylorus-preserving pancreaticoduodenectomy involving pylorotomy may reduce the incidence of delayed gastric emptying and preserve the long-term quality of life more than similar procedures.
authors.affiliation: First Department of Surgery, Kinki University School of Medicine, Osaka, Japan. nakai@surg1.med.kindai.ac.jp
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakai
authors.forename: Takashi
authors.initials: T
authors.lastname: Kawabe
authors.forename: Osamu
authors.initials: O
authors.lastname: Shiraishi
authors.forename: Kiyotaka
authors.initials: K
authors.lastname: Okuno
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Shiozaki
mesh_terms: D005260:Female; D005746:Gastric Emptying; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011708:Pylorus / Q000601:surgery*; D013272:Stomach Diseases / Q000453:epidemiology* / Q000503:physiopathology