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01.06.2015 | Original Article | Ausgabe 3/2015

European Surgery 3/2015

Antecolic anastomosis and delayed gastric emptying: still a benefit in patients without intra-abdominal complications?

Zeitschrift:
European Surgery > Ausgabe 3/2015
Autoren:
MD M. Beisani, MD, PhD C. Dopazo, MD L. Blanco, MD M. Caralt, MD, PhD G. Sapisochín, MD, PhD J-J Olsina, MD, PhD J. Balsells

Summary

Background/Aims

The etiology of delayed gastric emptying (DGE) after pylorus-preserving pancreatoduodenectomy (PPPD) is unclear. This study aimed to ascertain the incidence of DGE in a transmesocolic anastomosis (TA) versus an antecolic anastomosis (AA) group of patients.

Methods

Retrospective study including the last 40 consecutive patients with TA (2004–2006) and the first 40 consecutive patients with AA (2006–2010) performed at our centre. Preoperative, surgical and postoperative data were prospectively collected until patient discharge.

Results

No preoperative differences were found. Overall postoperative morbidity was higher in the TA group (75  vs 47 %; p = 0.012). No significant differences in DGE were found (TA: 35 % vs AA: 20 %; p = 0.1). Termino-terminal pancreatic anastomosis, gastrostomy, prophylactic somatostatin and the presence of intra-abdominal collections were associated with DGE. On multivariate analysis, only intra-abdominal collections (OR: 4.95 % CI: 1.36–11.8; p = 0.012) predicted DGE. Among patients without other surgical complications (n = 46), DGE rate was significantly higher in the TA group (TA: 38 % vs AA: 12 %, p = 0.04).

Conclusions

Overall, no significant differences in DGE were found between groups. AA could be a protective factor for DGE when no other surgical complications appear.

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