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Erschienen in: Journal of Gastrointestinal Surgery 8/2015

01.08.2015 | Review Article

Delayed Gastric Emptying After Pancreaticoduodenectomy: Is Subtotal Stomach Preserving Better or Pylorus Preserving?

verfasst von: Mena Hanna, Rahul Gadde, Leonardo Tamariz, Casey Allen, Jonathan Meizoso, Danny Sleeman, Alan Livingstone, Danny Yakoub

Erschienen in: Journal of Gastrointestinal Surgery | Ausgabe 8/2015

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Abstract

Background

Delayed gastric emptying (DGE) is one of the main complications after pancreaticoduodenectomy (PD). Literature review and meta-analysis were used to evaluate whether subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) may have less incidence than pylorus-preserving pancreaticoduodenectomy (PPPD).

Methods

Online search for studies comparing PPPD to SSPPD was done. Primary outcome was DGE. Quality of included studies was evaluated and heterogeneity was assessed. Relative risk (RR) and 95 % confidence intervals (CI) were calculated from pooled data in RCTs and retrospective studies.

Results

Eight studies met our selection criteria, with a total of 663 patients undergoing pancreaticoduodenectomy; 309 underwent PPPD and 354 underwent SSPPD. Median age was 66 years. Average male/female ratio was 57 vs. 43 %, respectively. There was lower incidence of DGE with SSPPD (RR 0.527; 95 % CI 0.363–0.763; p < 0.001) and less nasogastric tube days with SSPPD (RR −0.544; 95 % CI −876 to −0.008; p = 0.047). Operative blood loss was more in SSPPD (RR 0.285; 95 % CI 0.071–0.499; p = 0.009). There was no statistical difference between the two groups regarding length of hospital stay, incidence of pancreatic fistula, abscesses, overall morbidity, or postoperative mortality.

Conclusion

SSPPD was associated with less DGE than PPPD. Larger prospective randomized studies are needed to investigate the association of this result with other complications in more depth.
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Metadaten
Titel
Delayed Gastric Emptying After Pancreaticoduodenectomy: Is Subtotal Stomach Preserving Better or Pylorus Preserving?
verfasst von
Mena Hanna
Rahul Gadde
Leonardo Tamariz
Casey Allen
Jonathan Meizoso
Danny Sleeman
Alan Livingstone
Danny Yakoub
Publikationsdatum
01.08.2015
Verlag
Springer US
Erschienen in
Journal of Gastrointestinal Surgery / Ausgabe 8/2015
Print ISSN: 1091-255X
Elektronische ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-015-2816-1

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