title: Reconstruction following pancreaticoduodenectomy for patients who have previously undergone partial gastrectomy.
abstract: OBJECTIVE
  The present papaer compared the results of reconstructive procedure following pancreaticoduodenectomy (PD) with pancreaticojejunostomy in patients who have undergone partial gastrectomy previously.
  
  
  METHODS
  Twenty-two patients who had previously undergone partial gastrectomy with Billroth-I reconstruction for gastric ulcer or gastric cancer had subsequent PD and were available for this study. The patients were divided into 2 groups: those who underwent Billroth-I (Imanaga's and Cattell's) (N = 10) reconstruction and those who underwent Billroth-II (Child's) (N = 12) reconstruction.
  
  
  RESULTS
  One patient from each group developed a postoperative pancreatic fistula (grade B). Although, without significant difference, the Billroth-II group required nasogastric suction for a shorter duration than those of the Billroth-I group. Diet initiation and oral ingestion of solid foods could be safely resumed significantly earlier in the Billroth-II group. Delayed gastric emptying (DGE) was observed 40% in the Billroth-I group, and 8% in the Billroth-II group. The duration of hospitalization significantly shorter in the Billroth-II group.
  
  
  CONCLUSIONS
  The present study conclude that Billroth-II (Child's) reconstruction is an appropriate reconstructive procedure for preventing DGE after PD in patients who have previously undergone partial gastrectomy.
authors.affiliation: Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Ymashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005746:Gastric Emptying; D005763:Gastroenterostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D012086:Reoperation; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*; D013276:Stomach Ulcer / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome