title: Comparative study of gastric emptying and nutritional status after pylorus-preserving vs. subtotal stomach-preserving pancreaticoduodenectomy.
abstract: OBJECTIVE
  Delayed gastric emptying (DGE) is a specific, worrisome complication after pancreaticoduodenectomy (PPPD), whereas subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) that excises the pylorus ring seems to be effective in reducing DGE. This study compared gastric emptying and nutritional status between PPPD and SSPPD over 1 year.
  
  
  METHODS
  From June 2003 to December 2007, 41 patients (PPPD: 33, SSPPD: 8) were enrolled in this study to evaluate differences in gastric emptying and nutritional status at 1, 3, 6, 9 and 12 months after pancreaticoduodenectomy. Gastric emptying was evaluated by 13C-acetate breath test. Nutritional status (body weight, serum levels of total protein, albumin and total cholesterol) was similarly assessed.
  
  
  RESULTS
  At 1 month, gastric emptying evaluated at T1/2 (half-emptying time) was significantly prolonged in the PPPD but not in the SSPPD compared to the preoperative level. Thereafter, T1/2 was decreased and showed function significantly better preserved at 3, 6 and 12 months after PPPD than after SSPPD. Body weight recovery was significantly better at 6 and 12 months after PPPD than after SSPPD. Other nutritional parameters were better preserved in the PPPD during 1-year follow-up.
  
  
  CONCLUSIONS
  PPPD seems to be a more suitable surgical procedure than SSPPD in regard to gastric emptying and nutritional status.
authors.affiliation: Department of Surgical Oncology and Regulation of Organ Function, Miyazaki University School of Medicine, Miyazaki, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Hiyoshi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Chijiiwa
authors.forename: Jiro
authors.initials: J
authors.lastname: Ohuchida
authors.forename: Naoya
authors.initials: N
authors.lastname: Imamura
authors.forename: Motoaki
authors.initials: M
authors.lastname: Nagano
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011708:Pylorus / Q000601:surgery*; D013270:Stomach / Q000601:surgery*