3 years ago

Delayed Gastric Emptying in Side-to-Side Gastrojejunostomy in Pancreaticoduodenectomy: Result of a Propensity Score Matching

Yuma Ebihara, Soichi Murakami, Yoichi M. Ito, Satoshi Hirano, Yo Kurashima, Takahiro Tsuchikawa, Toshiaki Shichinohe, Takehiro Noji, Toshimichi Asano, Yoshitsugu Nakanishi, Toru Nakamura, Akio Tsutaho, Kimitaka Tanaka, Keisuke Okamura

Abstract

Background

Delayed gastric emptying (DGE) is one of the most common morbidities of pancreaticoduodenectomy (PD). The aim of this study was to clarify whether the incidence of DGE can be reduced by side-to-side gastric greater curvature-to-jejunal anastomosis in subtotal stomach-preserving pancreaticoduodenectomy (SSPPD).

Methods

The clinical data of 253 patients who had undergone PD were examined. Of a total of 188 patients who had undergone SSPPD, a gastrojejunostomy (GJ) was performed with end-to-side anastomosis in 87 patients (SSPPD-ETS group), and a GJ was performed with a greater curvature side-to-jejunal side anastomosis in 101 patients (SSPPD-STS group). After propensity score matching, the matched cohort consisted of 74 patients in each group. The postoperative data were evaluated according to the International Study Group of Pancreatic Surgery grade of DGE.

Results

The total incidence of DGE was 9.4% in the SSPPD-ETS group and 4% in the SSPPD-STS group, with no significant difference (p = 0.1902). A significant difference was observed between the two groups in the incidence of DGE grade C (p = 0.0426).

Conclusions

The incidence of total DGE was not reduced statistically in the STS group compared with the ETS group, but reduced DGE grade C. Side-to-side anastomosis might be associated with a reduced incidence of DGE grade C.

Publisher URL: https://link.springer.com/article/10.1007/s11605-017-3540-9

DOI: 10.1007/s11605-017-3540-9

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