Type of gastrointestinal reconstruction affects postoperative recovery after pancreatic head resection

Masahiko Kawamoto, Hiroyuki Konomi, Kiichiro Kobayashi, Shuji Shimizu, Koji Yamaguchi, Masao Tanaka

研究成果: Contribution to journalArticle査読

13 被引用数 (Scopus)

抄録

Background/Purpose. The postoperative recovery of gastric motility with various reconstructions after pancreatic head resection has been reported. However, little is known about this recovery after pancreatic head resection with segmental duodenectomy (PHRSD). Some have attributed gastric stasis after pylorus-preserving pancreatoduodenectomy (PPPD) to tube gastrostomy, but its effect on gastric motility has not been investigated. In this study, the postoperative recovery after PHRSD and PPPD, and gastric motility with and without gastrostomy after PPPD were investigated. Methods. We analyzed the first appearance of gastric phase III motility, postoperative systemic status, and body weight (BW; n = 32). The Imanaga PPPD and PHRSD were compared because the procedures differ only in the length of the remaining duodenum. Traverso and Roux-en-Y PPPDs were compared because the two procedures are similar except for the creation of gastrostomy. Results. (1) Times to first appearance of gastric phase III motility and BW recovery were significantly better after PHRSD than after the Imanaga PPPD (P < 0.05). (2) Times to first gastric phase III motility and resumption of a regular diet as well as periods of gastric sump tube use and postoperative hospital stay were significantly shorter after the Roux-en-Y than after the Traverso PPPD (P < 0.05). Conclusions. Preservation of as long a portion of the duodenum as possible, the choice of a Roux-en-Y duodenojejunostomy, and the avoidance of peritoneal fixation of the gastric wall may be factors that improve the recovery of gastric motility and BW after pancreatic head resection.

本文言語英語
ページ(範囲)336-343
ページ数8
ジャーナルJournal of Hepato-Biliary-Pancreatic Surgery
13
4
DOI
出版ステータス出版済み - 7 2006

All Science Journal Classification (ASJC) codes

  • 外科
  • 肝臓学

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