Comparison of the postoperative outcome after a pancreatoduodenectomy using the Billroth I and II type of reconstruction

Ohtsuka Takao, Kenji Kitahara, Satoru Matsuyama, Tomonori Shimonishi, Yuji Nakafusa, Kohji Miyazaki

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Background/Aims: Several types of gastrointestinal reconstruction have been employed after a pancreatoduodenectomy (PD), however, it remains controversial as to which type is the most beneficial. The aim of this study was to investigate the effects of a gastrointestinal reconstruction on the postoperative outcome after PD. Methodology: The medical records of 68 patients who underwent a PD between 1994 and 2004 were retrospectively reviewed. A total of 28 patients underwent a Billroth I reconstruction while 40 had the Billroth II reconstruction. Both the occurrence of postoperative complications and the nutritional status were compared between the two groups. Results: The patient age, gender, preoperative symptoms, and operation profiles were the same between the two groups. The morbidity and mortality did not differ between the two groups; however, the prevalence of leakage after a hepaticojejunostomy was higher in the Billroth II group than that in the Billroth I group (23% vs. 0%, P=0.007). All cases of bile leakage were successfully treated by conservative therapy. The day that oral intake was resumed and the length of the hospital stay also did not differ between the two groups. Both groups showed a similar postoperative nutritional status after a PD, as assessed by body weight, the serum albumin and cholesterol concentrations, and the number of lymphocytes. Conclusions: Bile leakage tends to occur after a PD using a Billroth II reconstruction, however, this can be easily managed by conservative therapy, and it does not influence morbidity, the resumption of oral intake, or the length of hospital stay. Therefore, we could not clearly identify any advantages of one group or another in terms of postoperative complications and the nutrition status after PD. Further investigations from other points of view are therefore necessary to clarify the effect of a gastrointestinal reconstruction after PD.

Original languageEnglish
Pages (from-to)1570-1574
Number of pages5
JournalHepato-Gastroenterology
Volume54
Issue number77
Publication statusPublished - Jul 2007
Externally publishedYes

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Gastroenterostomy
Pancreaticoduodenectomy
Length of Stay
Nutritional Status
Bile
Morbidity
Lymphocyte Count
Serum Albumin
Medical Records
Cholesterol
Body Weight
Mortality

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Takao, O., Kitahara, K., Matsuyama, S., Shimonishi, T., Nakafusa, Y., & Miyazaki, K. (2007). Comparison of the postoperative outcome after a pancreatoduodenectomy using the Billroth I and II type of reconstruction. Hepato-Gastroenterology, 54(77), 1570-1574.

Comparison of the postoperative outcome after a pancreatoduodenectomy using the Billroth I and II type of reconstruction. / Takao, Ohtsuka; Kitahara, Kenji; Matsuyama, Satoru; Shimonishi, Tomonori; Nakafusa, Yuji; Miyazaki, Kohji.

In: Hepato-Gastroenterology, Vol. 54, No. 77, 07.2007, p. 1570-1574.

Research output: Contribution to journalReview article

Takao, O, Kitahara, K, Matsuyama, S, Shimonishi, T, Nakafusa, Y & Miyazaki, K 2007, 'Comparison of the postoperative outcome after a pancreatoduodenectomy using the Billroth I and II type of reconstruction', Hepato-Gastroenterology, vol. 54, no. 77, pp. 1570-1574.
Takao, Ohtsuka ; Kitahara, Kenji ; Matsuyama, Satoru ; Shimonishi, Tomonori ; Nakafusa, Yuji ; Miyazaki, Kohji. / Comparison of the postoperative outcome after a pancreatoduodenectomy using the Billroth I and II type of reconstruction. In: Hepato-Gastroenterology. 2007 ; Vol. 54, No. 77. pp. 1570-1574.
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AU - Takao, Ohtsuka

AU - Kitahara, Kenji

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AU - Shimonishi, Tomonori

AU - Nakafusa, Yuji

AU - Miyazaki, Kohji

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N2 - Background/Aims: Several types of gastrointestinal reconstruction have been employed after a pancreatoduodenectomy (PD), however, it remains controversial as to which type is the most beneficial. The aim of this study was to investigate the effects of a gastrointestinal reconstruction on the postoperative outcome after PD. Methodology: The medical records of 68 patients who underwent a PD between 1994 and 2004 were retrospectively reviewed. A total of 28 patients underwent a Billroth I reconstruction while 40 had the Billroth II reconstruction. Both the occurrence of postoperative complications and the nutritional status were compared between the two groups. Results: The patient age, gender, preoperative symptoms, and operation profiles were the same between the two groups. The morbidity and mortality did not differ between the two groups; however, the prevalence of leakage after a hepaticojejunostomy was higher in the Billroth II group than that in the Billroth I group (23% vs. 0%, P=0.007). All cases of bile leakage were successfully treated by conservative therapy. The day that oral intake was resumed and the length of the hospital stay also did not differ between the two groups. Both groups showed a similar postoperative nutritional status after a PD, as assessed by body weight, the serum albumin and cholesterol concentrations, and the number of lymphocytes. Conclusions: Bile leakage tends to occur after a PD using a Billroth II reconstruction, however, this can be easily managed by conservative therapy, and it does not influence morbidity, the resumption of oral intake, or the length of hospital stay. Therefore, we could not clearly identify any advantages of one group or another in terms of postoperative complications and the nutrition status after PD. Further investigations from other points of view are therefore necessary to clarify the effect of a gastrointestinal reconstruction after PD.

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