Impact of Roux-en-Y reconstruction with isolated pancreatic drainage on delayed gastric emptying after pancreaticoduodenectomy
10.3760/cma.j.cn113884-20201124-00599
- VernacularTitle:胆胰分离式Roux-en-Y消化道重建对胰十二指肠切除术后胃排空延迟的影响
- Author:
Shaohong WANG
1
;
Wenxuan ZHANG
;
Shigang GUO
;
Chunmin NING
;
Aolei LI
;
Xinliang KONG
;
Xiangtao WANG
;
Shangsheng LI
;
Shan KE
;
Jun GAO
;
Jian KONG
;
Qiang LI
;
Wenbing SUN
Author Information
1. 首都医科大学附属北京朝阳医院西院肝胆胰脾外科 100043
- Keywords:
Pancreaticoduodenectomy;
Postoperative complications;
Gastric emptying
- From:
Chinese Journal of Hepatobiliary Surgery
2021;27(6):415-420
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the impact of Roux-en-Y reconstruction with isolated pancreatic drainage (RYR) on delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).Methods:The data of 203 patients who underwent PD at 5 clinical centers from January 2014 to June 2020 were collected. According to the method of reconstruction of the digestive tract, the patients were divided into the RYR group ( n=88) and the conventional loop reconstruction (CLR) group ( n=115). The incidence and severity of DGE were compared between groups. The risk factors of clinically relevant DGE (CR-DGE) after PD were analysed by univariate and multivariate analyses. Results:Of 203 patients, there were 124 males and 79 females, aged (61.6±10.2) years. The overall incidence of DEG was 27.6% (56/203). The incidence of CR-DGE in the RYR group was significantly lower than that in the CLR group [13.6%(12/88) vs 26.1%(30/115), P=0.030]. Patient age of more than 65 years ( OR=2.966, 95% CI: 1.162-8.842, P=0.024), clinically relevant pancreatic fistula ( OR=3.041, 95% CI: 1.122-8.238, P=0.029), ascites and abdominal infection ( OR=10.000, 95% CI: 2.552-39.184, P=0.001), and CLR ( OR=3.206, 95% CI: 1.162-8.842, P=0.024) were identified as independent risk factors for CR-DGE. The duration of hospitalization and hospital expenditure of patients were significantly increased in the CR-DGE group ( P<0.05). Conclusions:Patients over 65 years with clinically relevant pancreatic fistula, with ascites or abdominal infection after operation, had a higher evidence of CR-DGE. Roux-en-Y reconstruction with isolated pancreatic could helped to decrease the incidence of CR-DGE after PD.
