Pylorus-preserving pancreatoduodenectomy: Influence of a Billroth I versus a Billroth II type of reconstruction on gastric emptying

Autor: M. I. van Berge Henegouwen, T.M. van Gulik, M.J.H. Slooff, E.H. Eddes, T. H. Goei, D. J. Gouma
Přispěvatelé: Other departments
Jazyk: angličtina
Rok vydání: 2001
Předmět:
Zdroj: Digestive Surgery, 18(5), 376-380. KARGER
Digestive surgery, 18(5), 376-380. S. Karger AG
ISSN: 0253-4886
Popis: Background/Aim: Delayed gastric emptying (DGE) is a frequent problem after pylorus-preserving pancreatoduodenectomy. Important risk factors are the presence of intra-abdominal complications. Searching for other causes, this study evaluates the influence of the type of reconstruction after a pancreatoduodenectomy (Billroth I vs. Billroth II; B I vs. B II on DGE. Methods: A retrospective study was performed evaluating consecutive patients from two surgical institutes. 174 patients were included (B II type of reconstruction n = 123, period 1992–1996; B I type of reconstruction n = 51, period 1988–1998). DGE was defined by gastric stasis requiring nasogastric intubation for 10 days or more or the inability to tolerate a regular diet on or before the 14th postoperative day. Results: After a B I type of reconstruction, there was significantly longer nasogastric intubation period as compared with a B II type of reconstruction (B I median 13 days, range 4–47, B II median 6 days, range 1–40; p < 0.05). There was no difference in postoperative commencement of a normal diet. Also significantly more patients had DGE after a B I (76%) as compared with a B II type of reconstruction (32%; p < 0.05). Conclusions: The results of this study indicate a significantly higher incidence of DGE after a B I type of reconstruction as compared with a B II type reconstruction. The etiology remains speculative.
Databáze: OpenAIRE