title: Gastric marginal ulcer after pancreaticoduodenectomy with pancreaticogastrostomy due to delayed gastric emptying and Helicobacter pylori infection.
abstract: OBJECTIVE
  Marginal ulceration and delayed gastric emptying are considerable problems after pancreaticoduodenectomy. Helicobacter pylori (HP) are well known to be associated with gastritis, gastric ulcer and gastric cancer. Thus, we studied the relationship between marginal ulceration and delayed gastric emptying in the early postoperative period after pancreaticoduodenectomy with pancreaticogastrostomy.
  
  
  METHODS
  We retrospectively studied 58 patients who underwent pancreaticoduodenectomy with pancreaticogastrostomy. On the basis of the grade of delayed gastric emptying, these patients were divided into 2 groups-WS group; without/with slight delayed gastric emptying and MS group; moderate/severe delayed gastric emptying.
  
  
  RESULTS
  Two patients (3.4%) developed postoperative marginal ulcer, these 2 patients had no HP infection; moreover, they belonged to the MS group. Five patients in the WS group were infected with HP; although, postoperative marginal ulceration did not develop in these 5 patients.
  
  
  CONCLUSIONS
  Delayed gastric emptying might be a stronger promoting factor of postoperative marginal ulcer after pancreaticoduodenectomy with pancreaticogastrostomy rather than HP infection and prevention of delayed gastric emptying is important to reduce the occurrence rate of postoperative marginal ulcer. Our modified subtotal stomach-preserving pancreaticoduodenectomy is a useful procedure for preventing delayed gastric emptying and postoperative marginal ulcer after pancreaticoduodenectomy with pancreaticogastrostomy.
authors.affiliation: Department of Surgery, Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawasaki
authors.forename: Youichi
authors.initials: Y
authors.lastname: Kuboi
authors.forename: Nobutada
authors.initials: N
authors.lastname: Fukino
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Kida
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D005774:Gastrostomy / Q000009:adverse effects*; D016481:Helicobacter Infections / Q000150:complications / Q000382:microbiology*; D016480:Helicobacter pylori / Q000472:pathogenicity*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D013276:Stomach Ulcer / Q000209:etiology* / Q000382:microbiology / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome