title: Double loop reconstruction following pancreaticoduodenectomy for malignant tumor: Short-term outcome.
abstract: BACKGROUND
  To evaluate the use of a double loop reconstruction following pylorus preserving proximal pancreaticoduodenectomy (PPPPD).
  
  
  METHODS
  Morbidity and mortality were evaluated in 55 patients undergoing PPPPD for malignant tumors, followed by a double loop reconstruction.
  
  
  RESULTS
  The mean intra-operative blood loss was 908mL±531. In-hospital mortality was 5.4% (3/55 pts). The mean length of hospital stay was 17±5 days (range 12-45 days). Postoperative complications occurred in 25 patients (46.2%). Five patients developed an anastomotic leak, one biliary and four pancreatic (4/55; 7%). Delayed gastric emptying occurred in 8 patients (14.5%). Reoperation was required in two patients for hemorrhage.
  
  
  CONCLUSIONS
  A double loop alimentary reconstruction following PPPPD led to a low incidence of DGE and pancreatic fistula. Although mortality rate was higher than that reported by referral centres, this technique has been performed in a not specialized unit attaining acceptable results.
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy. Electronic address: limpao@libero.it.
authors.forename: Paolo
authors.initials: P
authors.lastname: Limongelli
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Alessandro
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Parisi
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Pirozzi
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Bondanese
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Colella
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Docimo
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: Gianmattia
authors.initials: G
authors.lastname: Del Genio
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Del Genio
authors.affiliation: XI Division of General and Obesity Surgery, Second University of Naples, Naples, Italy.
authors.forename: Ludovico
authors.initials: L
authors.lastname: Docimo
keywords: Double loop; Pancreatic fistula; Pancreaticoduodenectomy; Periampullary cancer