title: Does Braun enteroenterostomy reduce delayed gastric emptying after pancreaticoduodenectomy?
abstract: Whether an additional Braun enteroenterostomy is necessary in reducing delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) has not yet been well investigated. Herein, in this retrospective study, 395 consecutive cases of patients undergoing classic PD from 2009 to 2013 were reviewed. Patients with and without Braun enteroenterostomy were compared in preoperative baseline characteristics, surgical procedure, postoperative diagnosis, and morbidity including DGE. The DGE was defined and classified by the International Study Group of Pancreatic Surgery recommendation. The incidence of DGE was similar in patients with or without Braun enteroenterostomy following PD (37/347, 10.7% vs 8/48, 16.7%, P = 0.220). The patients in the 2 groups were not different in patient characteristics, lesions, surgical procedure, or postoperative complications, although patients without Braun enteroenterostomy more frequently presented postoperative vomiting than those with Braun enteroenterostomy (33.3% vs 15.3%, P = 0.002). Bile leakage, pancreatic fistula, and intraperitoneal abscess were risk factors for postoperative DGE (all P < 0.05). Prokinetic agents and acupuncture were effective in symptom relief of DGE in 24 out of 45 patients and 12 out of 14 patients, respectively.The additional Braun enteroenterostomy following classic PD was not associated with a decreased rate of DGE. Postoperative abdominal complications were strongly correlated with the onset of DGE. Prokinetic agents and acupuncture could be utilized in some patients with DGE.
authors.affiliation: Department of Hepatobiliary Surgery (X-FZ, G-ZY, Q-GL, X-ML, BW, LY, S-NL, YL); Institute of Advanced Surgical Technology and Engineering (X-FZ, X-ML, YL); Department of Chinese Acupuncture and Moxibustion, First Affiliated Hospital of Medical College, Xi'an Jiaotong University (H-YC), Xi'an, China.
authors.forename: Xu-Feng
authors.initials: XF
authors.lastname: Zhang
authors.forename: Guo-Zhi
authors.initials: GZ
authors.lastname: Yin
authors.forename: Qing-Guang
authors.initials: QG
authors.lastname: Liu
authors.forename: Xue-Min
authors.initials: XM
authors.lastname: Liu
authors.forename: Bo
authors.initials: B
authors.lastname: Wang
authors.forename: Liang
authors.initials: L
authors.lastname: Yu
authors.forename: Si-Nan
authors.initials: SN
authors.lastname: Liu
authors.forename: Hong-Ying
authors.initials: HY
authors.lastname: Cui
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology / Q000503:physiopathology; D026881:Acupuncture; D057868:Anastomotic Leak / Q000209:etiology / Q000503:physiopathology; D000932:Antiemetics / Q000627:therapeutic use; D004294:Domperidone / Q000627:therapeutic use; D004766:Enterostomy / Q000009:adverse effects / Q000379:methods*; D004917:Erythromycin / Q000627:therapeutic use; D005260:Female; D005746:Gastric Emptying / Q000502:physiology*; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008787:Metoclopramide / Q000627:therapeutic use; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology / Q000503:physiopathology; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D013272:Stomach Diseases / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D013997:Time Factors; D014839:Vomiting / Q000209:etiology
chemical_list: D000932:Antiemetics; D005765:Gastrointestinal Agents; D004294:Domperidone; D004917:Erythromycin; D008787:Metoclopramide
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