Postoperative delayed emptying in pylorus-preserving pancreatoduodenectomy using pancreaticogastrostomy: comparison of the reconstruction position.

BACKGROUND/AIMS: We frequently use pancreaticogastrostomy after pylorus-preserving pancreatoduodenectomy (PpPD). Although it is a useful and effective technique, it sometimes requires prolonged delayed emptying. We considered the best position for pancreaticogastrostomy in such a way as to reduce this period of delayed emptying.

MATERIAL AND METHOD

From 1991 to 1996, 17 patients whose blood sugar was controlled and who were kept on H2 blocker were selected from among 25 patients who underwent PpPD and were reconstructed by pancreaticogastrostomy. We investigated the history of the relationship between reconstruction position and delayed emptying, reconstruction position and minor leakage, minor leakage and delayed emptying, reconstruction position and stomach mobility without leakage.

RESULTS

The delayed emptying was shorter for a reconstruction position in the area above the angulus rather than below it.

CONCLUSION

The results suggest that the area above the angulus is the preferred site for pancreaticogastrostomy after PpPD.