Does Braun enteroenterostomy reduce delayed gastric emptying after pancreaticoduodenectomy?

Whether an additional Braun enteroenterostomy is necessary in reducing delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) has not yet been well investigated. Herein, in this retrospective study, 395 consecutive cases of patients undergoing classic PD from 2009 to 2013 were reviewed. P...

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Bibliographic Details
Published in:Medicine (Baltimore) 2014-08, Vol.93 (7), p.e48-e48
Main Authors: Zhang, Xu-Feng, Yin, Guo-Zhi, Liu, Qing-Guang, Liu, Xue-Min, Wang, Bo, Yu, Liang, Liu, Si-Nan, Cui, Hong-Ying, Lv, Yi
Format: Article
Language:English
Subjects:
Abdominal Abscess - etiology
Abdominal Abscess - physiopathology
Acupuncture
Anastomotic Leak - etiology
Anastomotic Leak - physiopathology
Antiemetics - therapeutic use
Domperidone - therapeutic use
Enterostomy - adverse effects
Enterostomy - methods
Erythromycin - therapeutic use
Female
Gastric Emptying - physiology
Gastrointestinal Agents - therapeutic use
Humans
Male
Metoclopramide - therapeutic use
Middle Aged
Pancreatic Fistula - etiology
Pancreatic Fistula - physiopathology
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy - adverse effects
Postoperative Complications - etiology
Postoperative Complications - physiopathology
Postoperative Complications - therapy
Retrospective Studies
Risk Factors
Stomach Diseases - etiology
Stomach Diseases - physiopathology
Stomach Diseases - therapy
Time Factors
Vomiting - etiology
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Summary:Whether an additional Braun enteroenterostomy is necessary in reducing delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD) has not yet been well investigated. Herein, in this retrospective study, 395 consecutive cases of patients undergoing classic PD from 2009 to 2013 were reviewed. Patients with and without Braun enteroenterostomy were compared in preoperative baseline characteristics, surgical procedure, postoperative diagnosis, and morbidity including DGE. The DGE was defined and classified by the International Study Group of Pancreatic Surgery recommendation. The incidence of DGE was similar in patients with or without Braun enteroenterostomy following PD (37/347, 10.7% vs 8/48, 16.7%, P = 0.220). The patients in the 2 groups were not different in patient characteristics, lesions, surgical procedure, or postoperative complications, although patients without Braun enteroenterostomy more frequently presented postoperative vomiting than those with Braun enteroenterostomy (33.3% vs 15.3%, P = 0.002). Bile leakage, pancreatic fistula, and intraperitoneal abscess were risk factors for postoperative DGE (all P < 0.05). Prokinetic agents and acupuncture were effective in symptom relief of DGE in 24 out of 45 patients and 12 out of 14 patients, respectively.The additional Braun enteroenterostomy following classic PD was not associated with a decreased rate of DGE. Postoperative abdominal complications were strongly correlated with the onset of DGE. Prokinetic agents and acupuncture could be utilized in some patients with DGE.
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000000048