TY - JOUR
T1 - Antecolic reconstruction is associated with a lower incidence of delayed gastric emptying compared to retrocolic technique after Whipple or pylorus-preserving pancreaticoduodenectomy
AU - Qiu, Jianguo
AU - Li, Ming
AU - Du, Chengyou
AU - Koniaris, Leonidas G.
N1 - Publisher Copyright:
© 2019 the Author(s).
PY - 2019
Y1 - 2019
N2 - Background:The aim of present study is to investigate the relationship between the antecolic (AC) route of gastrojejunostomy (GJ) after pancreaticoduodenectomy (PD) or duodenojejunostomy (DJ) reconstruction after pylorus-preserving pancreaticoduodenectomy (PPPD), and the incidence of delayed gastric emptying (DGE).Methods:An electronic search of 4 databases to identify all articles comparing AC and retrocolic (RC) reconstruction after PD or PPPD was performed.Results:Fifteen studies involving 2270 patients were included for final pooled analysis. The overall incidence of DGE was 27.2%. Meta-analysis results showed AC group had lower incidence of DGE (odds ratio, 0.29; 95% confidence interval [CI], 0.16-0.52, P<.0001) and shorter hospital length of stay (weight mean difference, -3.29; 95% CI, -5.2 to -1.39, P=.0007). Days until to liquid and solid diet in the AC group were also significantly earlier than that in the RC group (P=.0006 and P<.0001). There was no difference in operative time, incidence of pancreatic fistula and bile leakage, and mortality, respectively.Conclusions:AC route of GJ after PD or DJ after PPPD is associated with a lower incidence of DGE. However, the preferred route for GJ or DJ reconstruction remains to be investigated in well-powered, randomized, controlled trial.
AB - Background:The aim of present study is to investigate the relationship between the antecolic (AC) route of gastrojejunostomy (GJ) after pancreaticoduodenectomy (PD) or duodenojejunostomy (DJ) reconstruction after pylorus-preserving pancreaticoduodenectomy (PPPD), and the incidence of delayed gastric emptying (DGE).Methods:An electronic search of 4 databases to identify all articles comparing AC and retrocolic (RC) reconstruction after PD or PPPD was performed.Results:Fifteen studies involving 2270 patients were included for final pooled analysis. The overall incidence of DGE was 27.2%. Meta-analysis results showed AC group had lower incidence of DGE (odds ratio, 0.29; 95% confidence interval [CI], 0.16-0.52, P<.0001) and shorter hospital length of stay (weight mean difference, -3.29; 95% CI, -5.2 to -1.39, P=.0007). Days until to liquid and solid diet in the AC group were also significantly earlier than that in the RC group (P=.0006 and P<.0001). There was no difference in operative time, incidence of pancreatic fistula and bile leakage, and mortality, respectively.Conclusions:AC route of GJ after PD or DJ after PPPD is associated with a lower incidence of DGE. However, the preferred route for GJ or DJ reconstruction remains to be investigated in well-powered, randomized, controlled trial.
KW - delayed gastric emptying
KW - duodenojejunostomy
KW - gastrojejunostomy
KW - pancreaticoduodenectomy
KW - pylorus-preserving pancreaticoduodenectomy
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U2 - 10.1097/MD.0000000000016663
DO - 10.1097/MD.0000000000016663
M3 - Review article
C2 - 31441841
AN - SCOPUS:85071504473
SN - 0025-7974
VL - 98
JO - Medicine (United States)
JF - Medicine (United States)
IS - 34
M1 - e16663
ER -