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

M. Beisani, C. Dopazo, L. Blanco, M. Caralt, G. Sapisochín, J. J. Olsina, J. Balsells

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    © 2015, Springer-Verlag Wien. 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.
    Original languageEnglish
    Pages (from-to)101-106
    JournalEuropean Surgery - Acta Chirurgica Austriaca
    Volume47
    Issue number3
    DOIs
    Publication statusPublished - 18 Jun 2015

    Keywords

    • Antecolic anastomosis
    • Delayed gastric emptying
    • Gastroparesis
    • Pancreatic surgery
    • Pancreatoduodenectomy
    • Surgical complications

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