Our contrivances to diminish complications after pylorus-preserving pancreaticoduodenectomy

• Published in: International surgery Vol. 100; no. 5; pp. 882 - 890
• Main Authors: Shimura, Tatsuo, Suzuki, Hideki, Araki, Kenichiro, Kobayashi, Tsutomu, Yashima, Rei, Kohunato, Yasuhide, Okada, Ryou, Shibata, Masahiko, Kuwano, Hiroyuki, Takenoshita, Seiichi
• Format: Journal Article
• Language: English
• Published: Italy The International College of Surgeons, World Federation of General Surgeons and Surgical Specialists, Inc 01.05.2015
• Subjects: Adult; Aged; Aged, 80 and over; Hepatobiliary & Pancreatic Surgery; Humans; Length of Stay - statistics & numerical data; Middle Aged; Omentum - surgery; Pancreatic Diseases - surgery; Pancreaticoduodenectomy - methods; Postoperative Complications - prevention & control; Pylorus - surgery; Stents; Treatment Outcome; Omental wrapping; Pylorus-preserving pancreaticoduodenectomy (PPPD); Postoperative stay; Internal stent
• ISSN: 0020-8868; 2520-2456
• DOI: 10.9738/INTSURG-D-14-00246.1

The objective of this study is to diminish postoperative complications after pylorus-preserving pancreaticoduodenectomy. Pylorus-preserving pancreaticoduodenectomy is still associated with major complications, especially leakage at pancreatojejunostomy and delayed gastric emptying. Traditional pylorus-preserving pancreaticoduodenectomy was performed in group A, while the novel procedure, an antecolic vertical duodenojejunostomy and internal pancreatic drainage with omental wrapping, was performed in group B (n = 40 each). We compared the following characteristics between the 2 groups: operation time, blood loss, time required before removal of nasogastric tube and resumption of food intake, length of hospital stay, and postoperative complications. The novel procedure required less time and was associated with less blood loss (both P < 0.0001). In the comparison of the 2 groups, group B showed less time for removal of nasogastric tubes and resumption of food intake, shorter hospital stays, and fewer postoperative complications (all P < 0.0001). The novel procedure appears to be a safe and effective alternative to traditional pancreaticoduodenectomy techniques.