Pylorus resection in partial pancreaticoduodenectomy: impact on delayed gastric emptying

Abstract Background Partial pancreaticoduodenectomy (PD) is complicated by postoperative delayed gastric emptying (DGE) in up to 45% of patients. The aim of this study was to evaluate the impact of pylorus resection on DGE following PD. Methods Forty PD patients underwent pylorus resection with comp...

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Bibliographic Details
Published in:The American journal of surgery 2013-09, Vol.206 (3), p.296-299
Main Authors: Hackert, Thilo, M.D, Hinz, Ulf, M.Sc, Hartwig, Werner, M.D, Strobel, Oliver, M.D, Fritz, Stefan, M.D, Schneider, Lutz, M.D, Werner, Jens, M.D, Büchler, Markus W., M.D
Format: Article
Language:English
Subjects:
Adult
Age
Aged
Aged, 80 and over
Body mass index
Case-Control Studies
Delayed gastric emptying
Female
Gastroparesis - epidemiology
Gastroparesis - physiopathology
Humans
Incidence
Intensive care
Length of Stay - statistics & numerical data
Male
Middle Aged
Morbidity
Mortality
Pancreaticoduodenectomy - methods
Partial pancreaticoduodenectomy
Patients
Postoperative Complications - epidemiology
Postoperative Complications - physiopathology
Prospective Studies
Pylorus - surgery
Pylorus resection
Software
Statistics, Nonparametric
Surgery
Surgical outcomes
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Summary:Abstract Background Partial pancreaticoduodenectomy (PD) is complicated by postoperative delayed gastric emptying (DGE) in up to 45% of patients. The aim of this study was to evaluate the impact of pylorus resection on DGE following PD. Methods Forty PD patients underwent pylorus resection with complete stomach preservation (prPD). They were compared with a pair-matched group of PD patients with pylorus preservation (ppPD) in a 1:1 ratio (age, sex, histopathology). The objectives were operative parameters, DGE incidence, morbidity, and length of hospital stay. Results DGE incidence was significantly lower after prPD (15.0% vs 42.5%; P = .0066). Operative parameters and surgical morbidity (other than DGE) were not different (27.5% prPD vs 30.0% ppPD). There was a trend toward a shorter hospital stay in the prPD group. Conclusions Resection of the pylorus with stomach preservation significantly reduces the frequency of DGE after PD without showing any disadvantage when compared with standard ppPD. This finding could be of high relevance for the clinical practice in routine PD and should consequently be investigated in a large randomized multicenter trial to create further evidence.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2012.10.042