Subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) prevents postoperative delayed gastric emptying

• Published in: Journal of surgical oncology Vol. 102; no. 6; pp. 615 - 619
• Main Authors: Kurahara, Hiroshi, Takao, Sonshin, Shinchi, Hiroyuki, Mataki, Yuko, Maemura, Kousei, Sakoda, Masahiko, Ueno, Shinichi, Natsugoe, Shoji
• Format: Journal Article
• Language: English
• Published: Hoboken Wiley Subscription Services, Inc., A Wiley Company 01.11.2010
• Subjects: Adult; Aged; Aged, 80 and over; Female; Gastric Emptying; Humans; lymph node dissection; Lymph Node Excision; Male; Middle Aged; Pancreatic Neoplasms - surgery; Pancreaticoduodenectomy - adverse effects; Pancreaticoduodenectomy - methods; postoperative complication; Postoperative Complications - prevention & control; Pylorus - surgery; pylorus-preserving pancreaticoduodenectomy (PPPD); Reconstructive Surgical Procedures
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.21687

Background and Objectives Delayed gastric emptying (DGE) is one of main complications after pylorus‐preserving pancreaticoduodenectomy (PPPD) with regional lymph node dissection (RLND). The aim of this study was to retrospectively investigate whether subtotal stomach‐preserving PD (SSPPD) decreased incidence of DGE. Methods This study included 112 consecutive patients underwent PPPD (n = 48) or SSPPD (n = 64) with/without RLND. DGE was classified into three categories (grades A, B, and C) according to the guideline proposed by the International Study Group of Pancreatic Surgery. Results The incidence of DGE grade B/C in SSPPD with RLND (13.0%) was lower compared with that (34.8%) in PPPD with RLND (P = 0.0326). Consequently, the mean length of postoperative hospital stay of SSPPD with RLND group was significantly shorter than that of PPPD with RLND (P = 0.0476). Conclusions SSPPD could be substituted for PPPD due to decreased postoperative DGE when RLND is involved. A randomized control trial of SSPPD versus PPPD should be considered. J. Surg. Oncol. 2010;102:615–619. © 2010 Wiley‐Liss, Inc.