Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction
Background: After pylorus-resecting pancreatoduodenectomy (PrPD), delayed gastric emptying (DGE) might partially be attributed to biliary reflux. We investigated whether the incidence of primary DGE is reduced after Roux-en-Y instead of Billroth-II reconstruction. Methods: Patients undergoing PrPD f...
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Elsevier
2024-12-01
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| Series: | Surgery Open Science |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2589845024001283 |
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| author | Felix O. Hofmann Victoria S. Engelstädter Ughur Aghamaliyev Mathilda M. Knoblauch Elise Pretzsch Maximilian Weniger Jan G. D'Haese Bernhard W. Renz Jens Werner Matthias Ilmer |
| author_facet | Felix O. Hofmann Victoria S. Engelstädter Ughur Aghamaliyev Mathilda M. Knoblauch Elise Pretzsch Maximilian Weniger Jan G. D'Haese Bernhard W. Renz Jens Werner Matthias Ilmer |
| author_sort | Felix O. Hofmann |
| collection | DOAJ |
| description | Background: After pylorus-resecting pancreatoduodenectomy (PrPD), delayed gastric emptying (DGE) might partially be attributed to biliary reflux. We investigated whether the incidence of primary DGE is reduced after Roux-en-Y instead of Billroth-II reconstruction. Methods: Patients undergoing PrPD from 2016 to 2019 at a high-volume center were identified. Excluding causes of secondary DGE, we matched patients with Roux-en-Y and Billroth-II reconstruction in a 1:2 ratio and compared primary DGE. Results: In 24 vs. 48 (Roux-en-Y vs. Billroth-II) patients, DGE (grade B/C) incidence (20.8 % vs. 18.8 %; P = 1.000), nasogastric tube requirement (median 2 vs. 2 days; P = 0.844) and time to solid food intake (7 vs. 7 days; P = 0.933) were comparable. Univariable logistic regression showed no association between DGE and Roux-en-Y reconstruction (OR 1.47; P = 0.524), in contrast to age (1.08; P = 0.030) and pancreatic biochemical leak (4.98; P = 0.007). Conclusions: Primary DGE did not differ between Roux-en-Y and Billroth-II reconstruction after PrPD. Instead, age and postoperative pancreatic biochemical leak were associated with higher DGE risk. |
| format | Article |
| id | doaj-art-3e1270a408b2404fb019b981aad874b7 |
| institution | Kabale University |
| issn | 2589-8450 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Surgery Open Science |
| spelling | doaj-art-3e1270a408b2404fb019b981aad874b72024-12-14T06:31:57ZengElsevierSurgery Open Science2589-84502024-12-01224652Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstructionFelix O. Hofmann0Victoria S. Engelstädter1Ughur Aghamaliyev2Mathilda M. Knoblauch3Elise Pretzsch4Maximilian Weniger5Jan G. D'Haese6Bernhard W. Renz7Jens Werner8Matthias Ilmer9Department of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; Department of General, Visceral and Vascular Surgery, Agatharied Hospital, Hausham, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, GermanyDepartment of General, Visceral and Transplantation Surgery, Ludwig-Maximilians-University Hospital Munich, Marchioninistrasse 15, 81377 Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, German Cancer Research Center (DKFZ), Heidelberg, Germany; Corresponding author at: Department of General, Visceral and Transplantation Surgery, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany.Background: After pylorus-resecting pancreatoduodenectomy (PrPD), delayed gastric emptying (DGE) might partially be attributed to biliary reflux. We investigated whether the incidence of primary DGE is reduced after Roux-en-Y instead of Billroth-II reconstruction. Methods: Patients undergoing PrPD from 2016 to 2019 at a high-volume center were identified. Excluding causes of secondary DGE, we matched patients with Roux-en-Y and Billroth-II reconstruction in a 1:2 ratio and compared primary DGE. Results: In 24 vs. 48 (Roux-en-Y vs. Billroth-II) patients, DGE (grade B/C) incidence (20.8 % vs. 18.8 %; P = 1.000), nasogastric tube requirement (median 2 vs. 2 days; P = 0.844) and time to solid food intake (7 vs. 7 days; P = 0.933) were comparable. Univariable logistic regression showed no association between DGE and Roux-en-Y reconstruction (OR 1.47; P = 0.524), in contrast to age (1.08; P = 0.030) and pancreatic biochemical leak (4.98; P = 0.007). Conclusions: Primary DGE did not differ between Roux-en-Y and Billroth-II reconstruction after PrPD. Instead, age and postoperative pancreatic biochemical leak were associated with higher DGE risk.http://www.sciencedirect.com/science/article/pii/S2589845024001283Pancreatic ductal adenocarcinomaPylorus-resecting partial pancreatoduodenectomyDelayed gastric emptyingRoux-en-Y reconstructionBillroth-II reconstruction |
| spellingShingle | Felix O. Hofmann Victoria S. Engelstädter Ughur Aghamaliyev Mathilda M. Knoblauch Elise Pretzsch Maximilian Weniger Jan G. D'Haese Bernhard W. Renz Jens Werner Matthias Ilmer Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction Surgery Open Science Pancreatic ductal adenocarcinoma Pylorus-resecting partial pancreatoduodenectomy Delayed gastric emptying Roux-en-Y reconstruction Billroth-II reconstruction |
| title | Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction |
| title_full | Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction |
| title_fullStr | Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction |
| title_full_unstemmed | Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction |
| title_short | Primary delayed gastric emptying after pylorus-resecting pancreatoduodenectomy: A matched-pair comparison of Roux-en-Y vs. Billroth-II reconstruction |
| title_sort | primary delayed gastric emptying after pylorus resecting pancreatoduodenectomy a matched pair comparison of roux en y vs billroth ii reconstruction |
| topic | Pancreatic ductal adenocarcinoma Pylorus-resecting partial pancreatoduodenectomy Delayed gastric emptying Roux-en-Y reconstruction Billroth-II reconstruction |
| url | http://www.sciencedirect.com/science/article/pii/S2589845024001283 |
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