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Background
Antecolic reconstruction after pylorus-preserving pancreato
duo
denecto
my (PPPD) has been?reporte
d to
decrease the inci
dence of
delaye
d gastric e
mptying (DGE), which is one of the
main postoperative co
mplications. Subtotal sto
mach-preserving PD (SSPPD), in which
duo
denu
m an
d pylorus ring were re
move
d, was intro
duce
d for the purpose of
decreasing the inci
dence of DGE. This prospective ran
do
mize
d control stu
dy was perfor
me
d to assess whether antecolic reconstruction
decreases the inci
dence of DGE co
mpare
d with retrocolic reconstruction after SSPPD.
Materials and Methods
Forty-six patients were enrolled in this trial between May 2007 and June 2010. Twenty-two and 24 patients were randomized for the retrocolic and antecolic groups, respectively. The primary endpoint was DGE incidence.
Results
The overall incidence of DGE in the retrocolic group was significantly higher than that in the antecolic group (50 % mlns="""">versus 20.8 % , mlns="""">P = 0.0364). In particular, this difference was most striking in the incidence of DGE grade B/C (27.3 % mlns="""">versus 4.2 % , mlns="""">P = 0.0234). Furthermore, patients in the retrocolic group required significantly longer time to full resumption of diet compared with the antecolic group. No significant difference was observed in other postoperative complications between the two groups.
Conclusion
Antecolic reconstruction, and not retrocolic reconstruction, decreases DGE incidence after SSPPD.
