Reconstruction following pancreaticoduodenectomy for patients who have previously undergone partial gastrectomy.

BACKGROUND/AIMS: The present papaer compared the results of reconstructive procedure following pancreaticoduodenectomy (PD) with pancreaticojejunostomy in patients who have undergone partial gastrectomy previously.

METHODOLOGY

Twenty-two patients who had previously undergone partial gastrectomy with Billroth-I reconstruction for gastric ulcer or gastric cancer had subsequent PD and were available for this study. The patients were divided into 2 groups: those who underwent Billroth-I (Imanaga's and Cattell's) (N = 10) reconstruction and those who underwent Billroth-II (Child's) (N = 12) reconstruction.

RESULTS

One patient from each group developed a postoperative pancreatic fistula (grade B). Although, without significant difference, the Billroth-II group required nasogastric suction for a shorter duration than those of the Billroth-I group. Diet initiation and oral ingestion of solid foods could be safely resumed significantly earlier in the Billroth-II group. Delayed gastric emptying (DGE) was observed 40% in the Billroth-I group, and 8% in the Billroth-II group. The duration of hospitalization significantly shorter in the Billroth-II group.

CONCLUSIONS

The present study conclude that Billroth-II (Child's) reconstruction is an appropriate reconstructive procedure for preventing DGE after PD in patients who have previously undergone partial gastrectomy.