An antecolic Roux-en Y type reconstruction decreased delayed gastric emptying after pylorus-preserving pancreatoduodenectomy
An antecolic Roux-en Y type reconstruction decreased delayed gastric emptying after pylorus-preserving pancreatoduodenectomy
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DOI：
10.1007/s11605-008-0483-1
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发表时间：
2008-06-01
影响因子：
3.2
通讯作者：
Sueda, Taijiro
中科院分区：
文献类型：
--
作者：
Murakami, Yoshiaki;Uemura, Kenichiro;Sueda, Taijiro
本研究的目的是确定一种更好的手术方法，以减少保留幽门的胰十二指肠切除术（PPPD）后胃排空延迟（DGE）的发生率。回顾性收集了 132 名连续接受 PPPD 的胰胆疾病患者的数据。 PPPD后分别对54例和78例患者进行了结肠后Billroth I型重建（B-I组）和前结肠Roux-en Y型重建（R-Y组）。比较两组之间 DGE 的临床测量结果。 B-I组DGE发生率为81%，R-Y组为10%（P < 0.001）。单变量分析显示，重建类型（P<0.001）、手术时间（P=0.016）和术后并发症（P=0.001）与DGE显着相关。通过多变量分析，仅重建类型（P < 0.001）被确定为独立因素，与 DGE 相关。结肠前Roux-en Y型十二指肠空肠吻合术可能是PPPD后预防DGE发生的一种有用的重建方法。
The aim of this study was to identify a preferable procedure reducing the incidence of delayed gastric emptying (DGE) after pylorus-preserving pancreatoduodenectomy (PPPD). Data on 132 consecutive patients with pancreatobiliary disease, who underwent PPPD, were collected retrospectively. A retrocolic Billroth I type reconstruction (B-I group) and an antecolic Roux-en Y type reconstruction (R-Y group) were performed for 54 and 78 patients after PPPD, respectively. Clinical measures of DGE were compared between the two groups. The incidence of DGE was 81% in B-I group and 10% in R-Y group (P < 0.001). The type of reconstruction (P < 0.001), operative time (P=0.016), and postoperative complications (P=0.001) were significantly associated with DGE by univariate analysis. Only the type of reconstruction (P < 0.001) was identified as an independent factor, which was associated with DGE by multivariate analysis. An antecolic Roux-en Y type duodenojejunostomy could be a useful reconstruction method after PPPD to prevent the occurrence of DGE.