A new reconstruction method for preventing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy

Sugiyama, Masanori; Abe, Nobutsugu; Ueki, Hisayo; Masaki, Tadahiko; Mori, Toshiyuki; Atomi, Yutaka

doi:10.1016/j.amjsurg.2003.10.013

« Previous Next »The American Journal of Surgery
Volume 187, Issue 6 , Pages 743-746, June 2004

A new reconstruction method for preventing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy

Masanori Sugiyama, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
- Corresponding author. Tel.: +81-422-47-5511; fax: +81-422-47-9926
Nobutsugu Abe, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
Hisayo Ueki, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
Tadahiko Masaki, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
Toshiyuki Mori, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan
Yutaka Atomi, M.D.
- First Department of Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka, Tokyo 181-8611, Japan

Received 11 April 2003; received in revised form 17 October 2003

Abstract

Background

With the aim of preventing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy (PPPD), we devised a new reconstruction method in which the pancreas and the bile duct are anastomosed to the proximal jejunum brought through the transverse mesocolon, and the duodenum is antecolically anastomosed to the jejunum below the mesocolon. The right gastric artery is divided in order to place the stomach, the duodenum, and the jejunum in a straight line.

Methods

Thirty patients underwent PPPD with the new reconstruction method (n = 12) or the conventional method (all anastomoses performed retrocolically; n = 18). Early and late complications were compared between the two groups.

Results

Delayed gastric emptying occurred respectively in 1 patient (8%) and 13 patients (72%) operated on by the new and conventional method (P <0.001). The incidences of other complications did not differ significantly between the two groups.