Surgical techniques to prevent delayed gastric emptying after pancreaticoduodenectomy

作     者：Peng Duan Lu Sun Kai Kou Xin-Rui Li Ping Zhang Peng Duan;Lu Sun;Kai Kou;Xin-Rui Li;Ping Zhang

作者机构：Department of Hepatobiliary and Pancreatic SurgeryGeneral Surgery Centerthe First Hospital of Jilin UniversityChangchun 130021China Department of Dental ImplantologyHospital of StomatologyJilin UniversityChangchun 130021China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2024年第23卷第5期

页      面：449-457页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：Pancreaticoduodenectomy Delayed gastric emptying Postoperative complications Surgical techniques 

摘      要：Background: Delayed gastric emptying(DGE) is one of the most common complications after pancreaticoduodenectomy(PD). DGE represents impaired gastric motility without significant mechanical obstruction and is associated with an increased length of hospital stay, increased healthcare costs, and a high readmission rate. We reviewed published studies on various technical modifications to reduce the incidence of DGE. Data sources: Studies were identified by searching Pub Med for relevant articles published up to December 2022. The following search terms were used: “pancreaticoduodenectomy, “pancreaticojejunostomy, “pancreaticogastrostomy, “gastric emptying, “gastroparesis and “postoperative complications. The search was limited to English publications. Additional articles were identified by a manual search of references from key articles. Results: In recent years, various surgical procedures and techniques have been explored to reduce the incidence of DGE. Pyloric resection, Billroth II reconstruction, Braun s enteroenterostomy, and antecolic reconstruction may be associated with a decreased incidence of DGE, but more high-powered studies are needed in the future. Neither laparoscopic nor robotic surgery has demonstrated superiority in preventing DGE, and the use of staplers is controversial regarding whether they can reduce the incidence of DGE. Conclusions: Despite many innovations in surgical techniques, there is no surgical procedure that is superior to others to reduce DGE. Further larger prospective randomized studies are needed.