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Title: Reduction in delayed gastric emptying following non-pylorus preserving pancreaticoduodenectomy by addition of a Braun enteroenterostomy.
Austin Authors: Nikfarjam, Mehrdad ;Houli, Nezor;Tufail, Farrukh;Weinberg, Laurence ;Muralidharan, Vijayaragavan ;Christophi, Christopher 
Affiliation: Department of Surgery, University of Melbourne, Austin Health, Heidelberg, Victoria, Australia
Issue Date: 10-Sep-2012
Publication information: Jop : Journal of the Pancreas 2012; 13(5): 488-96
Abstract: Delayed gastric emptying is a major cause of morbidity following pancreaticoduodenectomy.The impact of a Braun enteroenterostomy on delayed gastric emptying, used in reconstruction following classic pancreaticoduodenectomy, was assessed.Forty-four consecutive patients undergoing non-pylorus preserving pancreaticoduodenectomy from 2009 to 2011 by a single surgeon were included in this study.The first 20 patients had a standard antecolic gastroenterostomy and the subsequent 24 had the addition of a Braun enteroenterostomy.Patient characteristics, the extent of surgery, surgical findings and tumor characteristics were similar between the two groups. The delayed gastric emptying rate in the Braun enteroenterostomy (1/24, 4.2%) was significantly lower (P=0.008) than the standard reconstruction group (7/20, 35.0%). In the standard group, 6 of 7 cases (85.7%) of delayed gastric emptying were class C in nature. After exclusion of 8 total pancreatectomy patients, the pancreatic fistula rate in the Braun enteroenterostomy group (4/19, 21.1%) was similar (0.706) to the standard reconstruction group (5/17, 29.4%) as was the median length of hospital stay (10 days vs. 15 days; P=0.291). Braun enteroenterostomy technique was the only significant independent factor associated with reduced delayed gastric emptying with an odds ratio of 0.08 (95% confidence interval: 0.01-0.73; P=0.025).The use of Braun enteroenterostomy following non-pylorus preserving pancreaticoduodenectomy appears to result in a significant reduction in delayed gastric emptying.
Gov't Doc #: 22964955
Journal: JOP : Journal of the pancreas
Type: Journal Article
Subjects: Abdominal Pain.etiology
Aged, 80 and over
Gastric Emptying
Gastroenterostomy.adverse effects.methods
Middle Aged
Multivariate Analysis
Pancreatic Fistula.etiology
Pancreaticoduodenectomy.adverse effects
Postoperative Complications.etiology
Prospective Studies
Reconstructive Surgical Procedures.adverse effects.methods
Treatment Outcome
Appears in Collections:Journal articles

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