title: Horizontal vs. vertical incision on the anterior gastric wall in pancreaticogastrostomy.
abstract: OBJECTIVE
  Pancreaticogastrostomy during pancreaticoduodenectomy is associated with a very low rate of anastomotic leakage. However, gastric peristalsis is disturbed by pancreaticogastrostomy, which stabilizes the posterior stomach at that point leading to delayed gastric emptying. We evaluated which anterior gastrostomy, i.e. horizontal or vertical incision on the anterior gastric wall, is better for maintaining peristaltic movement of the anterior stomach to prevent delayed gastric emptying after pancreaticogastrostomy.
  
  
  METHODS
  We retrospectively studied 50 patients who underwent subtotal stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy. These patients were divided into 2 groups depending on the type of anterior gastrostomy: horizontal incision (H group) and vertical incision (V group).
  
  
  RESULTS
  The observed grade of delayed gastric emptying was lower in the V group than in the H group; however, the difference was not significant.
  
  
  CONCLUSIONS
  We conclude that a vertical incision on the anterior gastric wall is preferable for preventing delayed gastric emptying after a pancreaticogastrostomy.
authors.affiliation: Department of Surgery, Yokohama Central Hospital, Yokohama, Japan.
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Oida
authors.forename: Kenji
authors.initials: K
authors.lastname: Mimatsu
authors.forename: Hisao
authors.initials: H
authors.lastname: Kano
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: Kazutosi
authors.initials: K
authors.lastname: Kida
authors.forename: Sadao
authors.initials: S
authors.lastname: Amano
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005746:Gastric Emptying; D018589:Gastroparesis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control*; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D012189:Retrospective Studies; D016896:Treatment Outcome