Reconstruction following pancreaticoduodenectomy for patients who have previously undergone partial gastrectomy.
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.
Oida
Takatsugu
T
Department of Surgery, Social Insurance Yokohama Central Hospital, 268 Ymashita-cho, Naka-ku, Yokohama 231-8553, Japan. ooida.takatsugu@yokochu.jp
Mimatsu
Kenji
K
Kawasaki
Atsushi
A
Kano
Hisao
H
Kuboi
Youichi
Y
Amano
Sadao
S
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