title: Delayed gastric emptying after pancreatoduodenectomy.
abstract: BACKGROUND
  Antecolic reconstruction after pylorus-preserving pancreatoduodenectomy (PPPD) has been reported to decrease the incidence of delayed gastric emptying (DGE), which is one of the main postoperative complications. Subtotal stomach-preserving PD (SSPPD), in which duodenum and pylorus ring were removed, was introduced for the purpose of decreasing the incidence of DGE. This prospective randomized control study was performed to assess whether antecolic reconstruction decreases the incidence of DGE compared with retrocolic reconstruction after SSPPD.
  
  
  METHODS
  Forty-six patients were enrolled in this trial between May 2007 and June 2010. Twenty-two and 24 patients were randomized for the retrocolic and antecolic groups, respectively. The primary endpoint was DGE incidence.
  
  
  RESULTS
  The overall incidence of DGE in the retrocolic group was significantly higher than that in the antecolic group (50% versus 20.8%, P=0.0364). In particular, this difference was most striking in the incidence of DGE grade B/C (27.3% versus 4.2%, P=0.0234). Furthermore, patients in the retrocolic group required significantly longer time to full resumption of diet compared with the antecolic group. No significant difference was observed in other postoperative complications between the two groups.
  
  
  CONCLUSIONS
  Antecolic reconstruction, and not retrocolic reconstruction, decreases DGE incidence after SSPPD.
authors: Department of Surgical Oncology and Digestive Surgery, Graduate School of Medical Sciences, Kagoshima University, Kagoshima, Japan. h-krhr@m3.kufm.kagoshima-u.ac.jp
authors: Hiroshi
authors: H
authors: Kurahara
authors: Hiroyuki
authors: H
authors: Shinchi
authors: Kosei
authors: K
authors: Maemura
authors: Yuko
authors: Y
authors: Mataki
authors: Satoshi
authors: S
authors: Iino
authors: Masahiko
authors: M
authors: Sakoda
authors: Shinichi
authors: S
authors: Ueno
authors: Sonshin
authors: S
authors: Takao
authors: Shoji
authors: S
authors: Natsugoe
mesh_terms: D000368:Aged; D004386:Duodenum / Q000601:surgery; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005770:Gastrointestinal Neoplasms / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000379:methods* / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology* / Q000503:physiopathology; D011446:Prospective Studies; D011708:Pylorus / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors