Superiority of stapled side-to-side gastrojejunostomy over conventional hand-sewn end-to-side gastrojejunostomy for reducing the risk of primary delayed gastric emptying after subtotal stomach-preserving pancreaticoduodenectomyReportar como inadecuado




Superiority of stapled side-to-side gastrojejunostomy over conventional hand-sewn end-to-side gastrojejunostomy for reducing the risk of primary delayed gastric emptying after subtotal stomach-preserving pancreaticoduodenectomy - Descarga este documento en PDF. Documentación en PDF para descargar gratis. Disponible también para leer online.

Surgery Today

, Volume 47, Issue 8, pp 1007–1017

First Online: 23 March 2017Received: 12 August 2016Accepted: 25 December 2016

Abstract

Background and purposeDelayed gastric emptying DGE is the most common complication following pancreaticoduodenectomy PD. The clinical efficacy of stapled side-to-side anastomosis using a laparoscopic stapling device during alimentary reconstruction in PD is not well understood and its superiority over conventional hand-sewn end-to-side anastomosis remains controversial. The objective of this study was to evaluate the effectiveness of the stapled side-to-side anastomosis in preventing the development of DGE after PD.

MethodsThe subjects of this retrospective study were 137 patients who underwent pancreaticoduodenectomy, as subtotal stomach-preserving pancreaticoduodenectomy SSPPD; n = 130, or conventional whipple procedure n = 7 with Child reconstruction, between January 2010 and May 2014. The patients were divided into two groups according to whether they had had a stapled side-to-side anastomosis SA group; n = 57 or a conventional hand-sewn end-to-side anastomosis HA group; n = 80.

ResultsSA reduced the operative time SA vs. HA: 508 vs. 557 min, p = 0.028 and the incidence of delayed gastric emptying SA vs. HA: 21.1 vs. 46.3%, p = 0.003 and was associated with shorter hospitalization SA vs. HA: 33 vs. 39.5 days, p = 0.007. In this cohort, SA was the only significant factor contributing to a reduction in the incidence of DGE p = 0.002.

ConclusionsStapled side-to-side gastrojejunostomy reduced the operative time and the incidence of DGE following PD with Child reconstruction, thereby also reducing the length of hospitalization.

KeywordsSubtotal stomach-preserving pancreaticoduodenectomy Delayed gastric emptying Stapled side-to-side anastomosis Hand-sewn end-to-side anastomosis  Download fulltext PDF



Autor: Yasuhiro Murata - Akihiro Tanemura - Hiroyuki Kato - Naohisa Kuriyama - Yoshinori Azumi - Masashi Kishiwada - Shugo Mizuno

Fuente: https://link.springer.com/article/10.1007/s00595-017-1504-z







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