期刊
HPB
卷 16, 期 4, 页码 384-394出版社
WILEY-BLACKWELL
DOI: 10.1111/hpb.12153
关键词
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资金
- Japanese Ministry of Education, Culture, Sports, Science and Technology [17591417, 20591635]
- Grants-in-Aid for Scientific Research [20591635, 17591417] Funding Source: KAKEN
BackgroundAlthough an antecolic duodenojejunostomy was reported to reduce post-operative delayed gastric emptying (DGE) compared with a retrocolic duodenojejunostomy after a pylorus-preserving pancreaticoduodenectomy (PPPD), the long-term effects of these procedures have rarely been studied. The aim of this prospective, randomized, clinical trial was to investigate the influence of the reconstruction route on post-operative gastric emptying and nutrition. MethodsReconstruction was performed in 116 patients with an antecolic duodenojejunostomy (A group, n = 58) or a vertical retrocolic duodenojejunostomy (VR group, n = 58). Post-operative complications, including DGE, gastric emptying variables assessed by C-13-acetate breath test and nutrition, were compared between the two groups for 1 year post-operatively. ResultsThe incidence of DGE was not significantly different between the procedures (A group: 12.1%; VR group: 20.7%, P = 0.316). At post-operative month 1, gastric emptying was prolonged in the VR versus the A group but not significantly so. At post-operative month 6, gastric emptying was accelerated significantly in the A versus the VR group. Post-operative weight recovery was significantly better in the VR versus the A group at post-operative month 12 (percentage of pre-operative weight, A group: 93.8 1.2%; VR group: 98.5 +/- 1.3%, P = 0.015). ConclusionsA vertical retrocolic duodenojejunostomy was an acceptable procedure for the lower incidence of DGE and may contribute to better weight gain affected by moderate gastric emptying.
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