title: Stapled gastro/duodenojejunostomy shortens reconstruction time during pylorus-preserving pancreaticoduodenectomy.
abstract: OBJECTIVE
  To investigate whether a stapled technique is superior to the conventional hand-sewn technique for gastro/duodenojejunostomy during pylorus-preserving pancreaticoduodenectomy (PpPD).
  
  
  METHODS
  In October 2010, we introduced a mechanical anastomotic technique of gastro- or duodenojejunostomy using staplers during PpPD. We compared clinical outcomes between 19 patients who underwent PpPD with a stapled gastro/duodenojejunostomy (stapled anastomosis group) and 19 patients who underwent PpPD with a conventional hand-sewn duodenojejunostomy (hand-sewn anastomosis group).
  
  
  RESULTS
  The time required for reconstruction was significantly shorter in the stapled anastomosis group than in the hand-sewn anastomosis group (186.0 ± 29.4 min vs 219.7 ± 50.0 min, P = 0.02). In addition, intraoperative blood loss was significantly less (391.0 ± 212.0 mL vs 647.1 ± 482.1 mL, P = 0.03) and the time to oral intake was significantly shorter (5.4 ± 1.7 d vs 11.3 ± 7.9 d, P = 0.002) in the stapled anastomosis group than in the hand-sewn anastomosis group. There were no differences in the incidences of delayed gastric emptying and other postoperative complications between the groups.
  
  
  CONCLUSIONS
  These results suggest that stapled gastro/duodenojejunostomy shortens reconstruction time during PpPD without affecting the incidence of delayed gastric emptying.
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Sato
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Yabuki
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Shiro
authors.initials: S
authors.lastname: Kohi
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Mori
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Noritaka
authors.initials: N
authors.lastname: Minagawa
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Toshihisa
authors.initials: T
authors.lastname: Tamura
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Aiichiro
authors.initials: A
authors.lastname: Higure
authors.affiliation: Norihiro Sato, Kei Yabuki, Shiro Kohi, Yasuhisa Mori, Noritaka Minagawa, Toshihisa Tamura, Aiichiro Higure, Koji Yamaguchi, Department of Surgery 1, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Yamaguchi
mesh_terms: D000368:Aged; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004385:Duodenostomy / Q000009:adverse effects; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D018589:Gastroparesis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D020127:Recovery of Function; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000009:adverse effects; D013536:Suture Techniques / Q000009:adverse effects; D013997:Time Factors; D016896:Treatment Outcome
keywords: Delayed gastric emptying; Duodenojejunostomy; Gastrojejunostomy; Pylorus-preserving pancreaticoduodenectomy; Stapled anastomosis