Kobayashi Shinjiro, Koizumi Satoshi, Hatori Takashi, Segami Kouhei, Hoshino Hiroyuki, Otsubo Takehito
Department of Gastroenterological and General Surgery, St. Marianna University School of Medicine, Kawasaki, Japan.
International University of Health and Welfare, Mita Hospital, Tokyo, Japan.
Dig Surg. 2018;35(5):469-473. doi: 10.1159/000485847. Epub 2018 Jan 9.
BACKGROUND/AIMS: We describe a new reconstruction method of duodenojejunal anastomosis, the "vertical array reconstruction" (VAR) technique, following pylorus-preserving pancreatoduodenectomy (PPPD).
The VAR technique aligns the stomach, duodenum, and jejunal loop vertically along the body's longitudinal axis. It was performed in 120 consecutive patients (between June 2008 and October 2015) who underwent PPPD. We evaluated the incidence of delayed gastric emptying (DGE).
The incidence of DGE was 1.7% (n = 2). The proposed clinical grading classified these 2 cases of DGE as grade B. There was no DGE related to pancreatic fistula. The median duration to starting a solid diet was 3 days (range 3-5 days). The median operative time was 450 min (range 391-550 min).
The VAR technique allows the upper digestive tract to be aligned linearly and can minimize the risk of DGE after PPPD.
背景/目的：我们描述了一种在保留幽门的胰十二指肠切除术（PPPD）后十二指肠空肠吻合的新重建方法，即“垂直排列重建”（VAR）技术。
VAR技术使胃、十二指肠和空肠袢沿身体纵轴垂直排列。对120例连续接受PPPD的患者（2008年6月至2015年10月）实施该技术。我们评估了胃排空延迟（DGE）的发生率。
DGE的发生率为1.7%（n = 2）。所提出的临床分级将这2例DGE病例分类为B级。没有与胰瘘相关的DGE。开始固体饮食的中位时间为3天（范围3 - 5天）。中位手术时间为450分钟（范围391 - 550分钟）。
VAR技术可使上消化道呈线性排列，并可将PPPD后DGE的风险降至最低。
