The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non-pylorus-preserving pancreaticoduodenectomy

Klaus Sahora, Vicente Morales-Oyarvide, Sarah P Thayer, Christina R. Ferrone, Andrew L. Warshaw, Keith D. Lillemoe, Carlos Fernández-Del Castillo

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background Delayed gastric emptying (DGE) after pancreaticoduodenectomy increases length of hospital stay and costs, and may be influenced by surgical techniques. Methods We retrospectively compared 400 patients with antecolic gastrojejunostomy with 400 patients with retrocolic gastrojejunostomy for the occurrence of DGE. Results The prevalence of DGE was 15% in the antecolic group and 21% in the retrocolic group (P =.021), and median length of stay was shorter for the former (8 vs 10 days, P =.001). The difference was statistically significant with grade A DGE (9% vs 14%, P =.038), but not B or C. In a multivariate analysis, DGE was influenced by retrocolic reconstruction, as well as older age, chronic pancreatitis, preoperative bilirubin level, a history of previous upper abdominal surgery, and postoperative pancreatic fistula. Conclusions An antecolic gastrojejunostomy for classic non-pylorus-preserving pancreaticoduodenectomy is associated with a lower incidence of mild DGE (grade A) and a shorter length of stay.

Original languageEnglish (US)
Pages (from-to)1028-1035
Number of pages8
JournalAmerican Journal of Surgery
Volume209
Issue number6
DOIs
StatePublished - Jun 1 2015
Externally publishedYes

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Pancreaticoduodenectomy
Gastric Emptying
Gastric Bypass
Length of Stay
Pancreatic Fistula
Hospital Costs
Chronic Pancreatitis
Bilirubin
Multivariate Analysis
Incidence

Keywords

  • Antecolic
  • Delayed gastric emptying
  • Pancreaticoduodenectomy
  • Reconstruction
  • Retrocolic
  • Whipple resection

ASJC Scopus subject areas

  • Surgery

Cite this

The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non-pylorus-preserving pancreaticoduodenectomy. / Sahora, Klaus; Morales-Oyarvide, Vicente; Thayer, Sarah P; Ferrone, Christina R.; Warshaw, Andrew L.; Lillemoe, Keith D.; Fernández-Del Castillo, Carlos.

In: American Journal of Surgery, Vol. 209, No. 6, 01.06.2015, p. 1028-1035.

Research output: Contribution to journalArticle

Sahora, Klaus ; Morales-Oyarvide, Vicente ; Thayer, Sarah P ; Ferrone, Christina R. ; Warshaw, Andrew L. ; Lillemoe, Keith D. ; Fernández-Del Castillo, Carlos. / The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non-pylorus-preserving pancreaticoduodenectomy. In: American Journal of Surgery. 2015 ; Vol. 209, No. 6. pp. 1028-1035.
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