Watanabe Yusuke, Ohtsuka Takao, Kimura Hideyo, Matsunaga Taketo, Tamura Koji, Ideno Noboru, Aso Teppei, Miyasaka Yoshihiro, Ueda Junji, Takahata Shunichi, Tanaka Masao
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Am J Surg. 2015 Feb;209(2):369-77. doi: 10.1016/j.amjsurg.2014.05.007. Epub 2014 Jul 11.
Several recent studies have suggested that Braun enteroenterostomy (BEE) during conventional pancreatoduodenectomy might decrease delayed gastric emptying (DGE). However, the advantages and disadvantages of performing BEE during pylorus-preserving pancreatoduodenectomy (PPPD) remain controversial.
The medical records of 185 patients who underwent PPPD either with or without BEE between January 2008 and June 2013 were retrospectively reviewed, and the postoperative course of the 2 groups was compared.
Ninety-eight patients underwent PPPD with BEE and 87 without BEE. DGE occurred in 4% of patients with BEE and in 21% of those without BEE (P < .01). The addition of BEE did not affect postoperative complications other than DGE. By multivariate analysis, the omission of BEE was the only independent factor associated with DGE (odds ratio 5.04, 95% confidence interval: 1.59 to 19.66; P < .01).
BEE during PPPD reduced the incidence of DGE.
近期的几项研究表明，在传统胰十二指肠切除术中施行布劳恩肠肠吻合术（BEE）可能会降低胃排空延迟（DGE）的发生率。然而，在保留幽门的胰十二指肠切除术（PPPD）中施行BEE的利弊仍存在争议。
回顾性分析2008年1月至2013年6月期间185例行PPPD且行或未行BEE的患者的病历，并比较两组患者的术后病程。
98例患者行PPPD并施行BEE，87例未施行BEE。施行BEE的患者中4%发生DGE，未施行BEE的患者中21%发生DGE（P <.01）。除DGE外，施行BEE不影响术后并发症。多因素分析显示，未施行BEE是与DGE相关的唯一独立因素（比值比5.04，95%置信区间：1.59至19.66；P <.01）。
PPPD术中施行BEE可降低DGE的发生率。
