Vertical retrocolic duodenojejunostomy decreases delayed gastric emptying after pylorus-preserving pancreatoduodenectomy.
OBJECTIVE
With the aim of preventing delayed gastric emptying (DGE) after pylorus-preserving pancreatoduodenectomy (PPPD), the new reconstruction method namely vertical retrocolic duodenojejunostomy in which the stomach and duodenum are brought down through the left side of the transverse mesocolon in a straight line thereby allowing these organs apart from the excised and anastomosed field and food passage by gravity is presented.


METHODS
The preoperative and intraoperative factors, and short-term outcomes with special reference to DGE were compared between the two groups, PPPD (n = 12) and standard pancreatoduodenectomy (PD, n = 9). PD was similarly carried out except for hemigastrectomy for comparison. DGE was defined as a need for nasogastric tube decompression for 10 days or more.


RESULTS
Preoperative and intraoperative factors were not significantly different between the two groups. DGE was absent in both groups because nasogastric tube was removed within 7 days in all patients with a mean of postoperative day 3 in both groups. The days until liquid diet in the PPPD group were similar, but those until regular diet were significantly faster compared with the PD group. Postoperative hospital stay was similar between the two groups.


CONCLUSIONS
The current reconstruction method may minimize DGE after PPPD.
Chijiiwa
Kazuo
K
Department of Surgery 1, Miyazaki University School of Medicine, Miyazaki, Japan. kazuochi@med.miyazaki-u.ac.jp
Ohuchida
Jiro
J
Hiyoshi
Masahide
M
Nagano
Motoaki
M
Kai
Masahiro
M
Kondo
Kazuhiro
K
D000368:Aged; D000714:Anastomosis, Surgical; D004386:Duodenum / Q000601:surgery*; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D008953:Models, Anatomic; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010193:Pancreaticojejunostomy / Q000379:methods*; D011708:Pylorus / Q000473:pathology / Q000601:surgery*; D013270:Stomach / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome