Match!

Effect of Antecolic Reconstruction on Delayed Gastric Emptying After the Pylorus-Preserving Whipple Procedure

Published on Nov 1, 2005in Archives of Surgery
· DOI :10.1001/archsurg.140.11.1094
Mark Hartel18
Estimated H-index: 18
,
Moritz N. Wente36
Estimated H-index: 36
+ 5 AuthorsMarkus W. Büchler125
Estimated H-index: 125
Cite
Abstract
Hypothesis Antecolic duodenojejunostomy prevents delayed gastric emptying (DGE) after a pylorus-preserving Whipple (ppW) procedure better than retrocolic duodenojejunostomy. Design A single operation team’s experience with antecolic and retrocolic duodenojejunostomy in ppW is analyzed on a prospective database using univariate and multivariate models. Setting Tertiary referral center that focuses on pancreatic diseases. Patients and Interventions One hundred consecutive patients undergoing a ppW procedure with retrocolic reconstruction between January 1, 1996, and December 31, 2001, and 100 consecutive patients undergoing a ppW procedure with antecolic reconstruction between January 1, 2002, and December 31, 2003. Characteristics such as median age, median hospital stay, sex, diagnosis, previous operations, blood loss, surgical and medical complications, American Society of Anesthesiologists risk groups, stent implantation, and especially DGE were matched for the comparison groups. Main Outcome Measures We compared DGE, characteristics, and perioperative variables in patients with antecolic vs retrocolic reconstruction after ppW. Results The DGE occurred significantly more often in patients with retrocolic reconstruction than in those with antecolic reconstruction ( P P  = .25), sex ( P  = .48), and postoperative surgical ( P  = .19) and medical ( P  = .054) complications. The univariate analysis between patients with and without DGE did not show significant differences regarding diagnosis, previous operations, blood loss, surgical and medical complications, American Society of Anesthesiologists classification, or stent implantation. In the multivariate analysis, only the type of reconstruction ( P  = .006) and sex ( P  = .04) seemed to affect DGE. Conclusion We recommend antecolic duodenjejunostomy in patients undergoing a ppW procedure regardless of their diagnosis.
  • References (34)
  • Citations (117)
Cite
References34
Newest
Published on Jul 1, 2004in Archives of Surgery
Christian Schmidt46
Estimated H-index: 46
(IU: Indiana University),
Emilie Susan Powell13
Estimated H-index: 13
(IU: Indiana University)
+ 23 AuthorsThomas A. Broadie18
Estimated H-index: 18
(IU: Indiana University)
Hypothesis Pancreaticoduodenectomy (PD) is a safe procedure for a variety of periampullary conditions. Design Retrospective review of a prospectively collected database. Setting Academic tertiary care hospital. Patients A total of 516 consecutive patients who underwent PD. Main Outcome Measures Patient outcomes and survival factors. Results Pathological examination demonstrated 57% periampullary cancers, 22% chronic pancreatitis, 12% cystic neoplasms, 4% islet cell neoplasms, and 5% other. Fifty...
Published on May 1, 2004in British Journal of Surgery5.59
Markus Wagner27
Estimated H-index: 27
,
Claudio A. Redaelli25
Estimated H-index: 25
+ 3 AuthorsMarkus W. Büchler125
Estimated H-index: 125
(Heidelberg University)
Background: Mortality rates associated with pancreatic resection for cancer have steadily decreased with time, but improvements in long-term survival are less clear. This prospective study evaluated risk factors for survival after resection for pancreatic adenocarcinoma. Methods: Data from 366 consecutive patients recorded prospectively between November 1993 and September 2001 were analysed using univariate and multivariate models. Results: Fifty-eight patients (15·8 per cent) underwent surgical...
Published on Jan 1, 2004in Pancreas2.67
Olaf Horstmann7
Estimated H-index: 7
,
P. M. Markus18
Estimated H-index: 18
+ 1 AuthorsH. Becker42
Estimated H-index: 42
Published on Dec 1, 2003in Archives of Surgery
Markus W. Büchler125
Estimated H-index: 125
,
Markus Wagner27
Estimated H-index: 27
+ 3 AuthorsKaspar Z'graggen20
Estimated H-index: 20
Hypothesis Advances in specialized centers for pancreatic diseases have improved surgical morbidity and outcome. In the past, postoperative local complications (pancreatic fistulae) were causing most of the mortality. Now, more patients experience postoperative complications related to their comorbidity. Design To report a prospective audit of a single center's experience with pancreatic resection during an 8-year period. Setting Tertiary referral center focused on pancreatic diseases. Patients ...
Published on Sep 1, 2003in Archives of Surgery
John P. Duffy20
Estimated H-index: 20
,
O. Joe Hines53
Estimated H-index: 53
+ 7 AuthorsHoward A. Reber56
Estimated H-index: 56
(UCLA: University of California, Los Angeles)
Hypothesis After resection of an adenocarcinoma of the ampulla of Vater, certain clinical and pathologic characteristics influence long-term survival. Design Retrospective case series. Setting Major academic medical and pancreatic surgical center. Patients Fifty-five consecutive patients who underwent Whipple resection for ampullary adenocarcinoma from 1988 through 2001. Interventions Pylorus-preserving Whipple resection in 32 patients and standard Whipple resection in 23 patients. Main Outcome ...
Published on Jul 1, 2000in American Journal of Surgery2.20
Marcus E. Martignoni10
Estimated H-index: 10
(University of Bern),
Helmut Friess64
Estimated H-index: 64
(University of Bern)
+ 4 AuthorsMarkus W. Büchler125
Estimated H-index: 125
(University of Bern)
Background: Delayed gastric emptying is one of the most frequent postoperative complications after Whipple resection. In the present study we evaluated the role of enteral nutrition in the development of delayed gastric emptying after Whipple resection. Patients and methods: Between January 1996 and June 1998, 64 patients (30 female, 34 male) underwent a classic (n = 27) or pylorus-preserving (n = 37) Whipple resection. Two patients were excluded; 30 patients received enteral and 32 patients rec...
Published on Jul 1, 2000in British Journal of Surgery5.59
Markus W. Büchler125
Estimated H-index: 125
(University of Bern),
Helmut Friess64
Estimated H-index: 64
(University of Bern)
+ 3 AuthorsK. Z'graggen9
Estimated H-index: 9
(University of Bern)
Background Pancreatic resections can be performed with great safety. However, the morbidity rate is reported to be 40–60 per cent with a high prevalence of pancreatic complications. The aim of this study was to analyse complications after pancreatic head resection, with particular attention to morbidity and pancreatic fistula. Methods From November 1993 to May 1999, perioperative and postoperative data from 331 consecutive patients undergoing pancreatic head resection were recorded prospectively...
Published on Mar 1, 2000in Annals of Surgery9.48
Ramon E. Jimenez14
Estimated H-index: 14
,
Carlos Fernandez-del Castillo81
Estimated H-index: 81
+ 2 AuthorsAndrew L. Warshaw99
Estimated H-index: 99
Surgical therapy for chronic pancreatitis is reserved for patients with complications of the disease, intractable abdominal pain, or suspected underlying carcinoma. 1 The choice of operation for chronic pancreatitis is predicated on the two anatomical variants of the disease, which are distinguished by the size of the main pancreatic duct. 2 Large duct disease (>6 mm in diameter) accounts for approximately 40% of cases and is thought to develop from increased pressure in the pancreatic ductal sy...
Published on Aug 25, 1999in Langenbeck's Archives of Surgery2.09
O. Horstmann7
Estimated H-index: 7
(GAU: University of Göttingen),
H. Becker42
Estimated H-index: 42
(GAU: University of Göttingen)
+ 1 AuthorsR. Nustede14
Estimated H-index: 14
(GAU: University of Göttingen)
Background: Delayed gastric emptying (DGE) is the most frequent postoperative complication after pylorus-preserving pancreaticoduodenectomy (PPPD). This prospective, non-randomized study was undertaken to determine whether the incidence of DGE may be reduced by modifying the original reconstructive anatomy with a retrocolic duodenojejunostomy towards an antecolic duodenojejunostomy. Patients and methods: The study was comprised of 51 patients who underwent PPPD between August 1994 and November 1...
Published on Jun 10, 1999in European Journal of Surgery
Jean Michel Fabre19
Estimated H-index: 19
,
Jean Stéphane Burgel1
Estimated H-index: 1
+ 3 AuthorsJacques Domergue34
Estimated H-index: 34
Objective: To find out which factors influence the development of delayed gastric emptying (DGE) after pancreaticoduodenectomy with pancreaticogastrostomy.Design: Prospective clinical study.Setting: University hospital, France.Subjects: 88 patients of 103 consecutive patients who had had pancreaticoduodenectomies, November 1991-November 1997.Interventions: Whipple resection, and parenteral and enteral nutrition.Main outcome measures: Mortality, morbidity, and development of DGE (defined as the n...
Cited By117
Newest
Published on Feb 1, 2019in Hpb3.05
Alfred Adiamah1
Estimated H-index: 1
(NUH: Nottingham University Hospitals NHS Trust),
Reesha Ranat (NUH: Nottingham University Hospitals NHS Trust), Dhanwant Gomez7
Estimated H-index: 7
(NUH: Nottingham University Hospitals NHS Trust)
Abstract Background The need for nutritional support following pancreaticoduodenectomy is well recognised due to the high prevalence of malnutrition, but the optimal delivery route is still debated. This meta-analysis evaluated postoperative outcomes in patients receiving enteral or parenteral nutrition. Methods EMBASE, MEDLINE and Cochrane databases were searched to identify randomised controlled trials comparing enteral and parenteral nutrition in patients undergoing pancreaticoduodenectomy. T...
Published on Apr 1, 2019in Anz Journal of Surgery1.60
Johan Gagnière8
Estimated H-index: 8
(French Institute of Health and Medical Research),
Bertrand Le Roy5
Estimated H-index: 5
+ 5 AuthorsAurélien Dupré5
Estimated H-index: 5
Published on Feb 1, 2019in Asian Journal of Surgery1.56
Farzad Kakaei7
Estimated H-index: 7
(University of Tabriz),
Mohammadbasir Abolghasemi Fakhri (University of Tabriz)+ 3 AuthorsBehnam Sanei6
Estimated H-index: 6
(IUMS: Isfahan University of Medical Sciences)
Summary Background/Objective Delayed gastric emptying (DGE) is one of the most frequent complications after pyloric preserving pancreaticoduodenectomy (PPPD). The aim of this study is to evaluate the effect of antecolic versus retrocolic reconstruction of gastroentric anastomosis on DGE after PPPD. Methods 30 patients with diagnosis of operable periampullary malignancies who candidate for PPPD, randomized in two equal groups. Gastroentric reconstruction were done in two methods: antecolic and re...
Monica M. Dua13
Estimated H-index: 13
(Stanford University),
Anand Navalgund1
Estimated H-index: 1
+ 6 AuthorsBrendan C. Visser27
Estimated H-index: 27
(Stanford University)
Limited clinical indicators exist after pancreaticoduodenectomy to allow prediction of delayed gastric emptying (DGE). This study introduces a novel, noninvasive, wireless patch system capable of a...
Published on Sep 11, 2018in Zentralblatt Fur Chirurgie0.62
Jessica Hafke , Cornelius van Beekum + 3 AuthorsTim R. Glowka5
Estimated H-index: 5
Hintergrund Die Magenentleerungsstorung (MES) ist die haufigste Komplikation nach partieller Pankreatoduodenektomie. Wahrend eine ante- oder retrokolische Lage keinen Einfluss auf die Haufigkeit einer MES hat, wurde wiederholt postuliert, dass eine infrakolische im Gegensatz zur suprakolischen Duodenoenterostomie durch die gestreckte Position des Magenausgangs vorteilhaft ist. Beide Formen der retrokolischen Rekonstruktion wurden bislang nicht miteinander verglichen. Patienten 138 Patienten wurd...
Published on Feb 12, 2018
Jin He22
Estimated H-index: 22
(Johns Hopkins University),
John L. Cameron119
Estimated H-index: 119
(Johns Hopkins University)
Published on Jan 1, 2018in Surgery3.48
Motoi Nojiri2
Estimated H-index: 2
(Nagoya University),
Yukihiro Yokoyama35
Estimated H-index: 35
(Nagoya University)
+ 5 AuthorsMasato Nagino62
Estimated H-index: 62
(Nagoya University)
Abstract Background This study investigated the impact of gastrojejunal anatomic position on the incidence of delayed gastric emptying after pancreatoduodenectomy. Methods A total of 160 patients were included in the retrospective analysis. The relative anatomic position of the gastrojejunostomy was evaluated using coronal and sagittal plane computed tomography images on postoperative day 7; the coronal cardia anastomotic angle and the sagittal fundus anastomotic angle were measured. In the vali...
Published on Oct 1, 2017in Journal of Gastrointestinal Surgery2.69
Akio Tsutaho1
Estimated H-index: 1
(Hokkaido University),
Toru Nakamura13
Estimated H-index: 13
(Hokkaido University)
+ 11 AuthorsYo Kurashima9
Estimated H-index: 9
(Hokkaido University)
Background Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD).
Rajesh Panwar4
Estimated H-index: 4
(AIIMS: All India Institute of Medical Sciences),
Sujoy Pal17
Estimated H-index: 17
(AIIMS: All India Institute of Medical Sciences)
Background A number of definitions have been used for delayed gastric emptying (DGE) after pancreatoduodenectomy and the reported rates varied widely. The International Study Group of Pancreatic Surgery (ISGPS) definition is the current standard but it is not used universally. In this comprehensive review, we aimed to determine the acceptance rate of ISGPS definition of DGE, the incidence of DGE after pancreatoduodenectomy and the effect of various technical modifications on its incidence. Data ...
Published on Aug 1, 2017in Journal of Hepato-biliary-pancreatic Sciences2.35
Yasuro Futagawa11
Estimated H-index: 11
(Jikei University School of Medicine),
Masaru Kanehira2
Estimated H-index: 2
(Jikei University School of Medicine)
+ 6 AuthorsK. Yanaga32
Estimated H-index: 32
(Jikei University School of Medicine)
Background Delayed gastric emptying (DGE), a common postoperative complication of pancreaticoduodenectomy, is not considered a life-threatening complication. In the present study, we analyzed the risk factors for DGE and its impact on long-term prognosis. Methods We analyzed 383 patients who underwent pancreaticoduodenectomy between 2003 and 2010, dividing them into two groups according to DGE grade as defined by the International Study Group of Pancreatic Surgery: 243 without DGE (non-DGE group...
View next paperDelayed gastric emptying (DGE) after pancreatic surgery: a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS).