Zentralblatt fur Chirurgie · 2018
[The Impact of Supra- and Infracolic Reconstruction on Delayed Gastric Emptying Following Pancreatoduodenectomy].
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hafke Jessica, van Beekum Cornelius, Manekeller Steffen, Vilz Tim O, Kalff Jörg C, Glowka Tim R
Аннотация
BACKGROUND: Delayed gastric emptying (DGE) is the most frequent complication following pancreatoduodenectomy. While antecolic and retrocolic reconstruction does not influence the occurrence of DGE, infracolic reconstruction might alleviate DGE due to the vertical position of the distal stomach compared to supracolic reconstruction. Supra- and infracolic reconstruction have not yet been compared.
PATIENTS: 138 patients underwent pylorus-preserving pancreatoduodenectomy with retrocolic reconstruction at our department between 2011 and 2017. Of these, 105 were reconstructed with supracolic duodenoenterostomy and 33 with infracolic duodenoenterostomy. Patients were analysed with respect to demographic factors, diagnosis, pre-existing conditions, intraoperative characteristics, hospital stay and morbidity and mortality with special emphasis on DGE. All complications were classified according to the definitions of the International Study Group on Pancreatic Surgery.
RESULTS: The two groups were comparable with respect to diagnosis, medical history, intraoperative characteristics, morbidity and mortality. DGE was equally distributed between supra- and infracolic reconstruction (DGE stage A/B/C25/14/10 vs. 12/5/2, p = 0.274). With DGE, intensive care unit stay (p = 0.007) and hospital stay (p = 0.001) are significantly delayed. Risk factor analysis showed that pre-existing diabetes (p = 0.047) and major complications (Clavien stage III - V, p = 0.048) are risk factors for DGE, while the use of somatostain-analogues seems to have a protective effect (p = 0.021).
CONCLUSION: Supra- or infracolic reconstruction does not influence the frequency of DGE following pancreatoduodenectomy. When DGE occurs, hospital stay is delayed. Somatostatin analogues may act prophylactically on DGE.
PATIENTS: 138 patients underwent pylorus-preserving pancreatoduodenectomy with retrocolic reconstruction at our department between 2011 and 2017. Of these, 105 were reconstructed with supracolic duodenoenterostomy and 33 with infracolic duodenoenterostomy. Patients were analysed with respect to demographic factors, diagnosis, pre-existing conditions, intraoperative characteristics, hospital stay and morbidity and mortality with special emphasis on DGE. All complications were classified according to the definitions of the International Study Group on Pancreatic Surgery.
RESULTS: The two groups were comparable with respect to diagnosis, medical history, intraoperative characteristics, morbidity and mortality. DGE was equally distributed between supra- and infracolic reconstruction (DGE stage A/B/C25/14/10 vs. 12/5/2, p = 0.274). With DGE, intensive care unit stay (p = 0.007) and hospital stay (p = 0.001) are significantly delayed. Risk factor analysis showed that pre-existing diabetes (p = 0.047) and major complications (Clavien stage III - V, p = 0.048) are risk factors for DGE, while the use of somatostain-analogues seems to have a protective effect (p = 0.021).
CONCLUSION: Supra- or infracolic reconstruction does not influence the frequency of DGE following pancreatoduodenectomy. When DGE occurs, hospital stay is delayed. Somatostatin analogues may act prophylactically on DGE.