Braun enteroenterostomy reduces delayed gastric emptying: A systematic review and meta-analysis

Int J Surg. 2015 Nov;23(Pt A):75-81. doi: 10.1016/j.ijsu.2015.09.038. Epub 2015 Sep 16.

Abstract

Background: It remains controversial whether the additional Braun enteroenterostomy (BEE) is necessary in decreasing delayed gastric emptying (DGE) following pancreaticoduodenectomy (PD). This meta-analysis aims to assess the efficacy of the additional BEE in reducing DGE after PD.

Methods: PubMed, EMBASE, Science Citation Index and The Cochrane Library were searched to identify relevant studies. Articles published before May 15, 2015 comparing BEE with traditional gastrojejunostomy during PD were selected. The evaluated end points consist of intro-operative outcomes as well as postoperative complications.

Results: Seven observational clinical studies that recruited 1401 patients were included. This meta-analysis indicated that the occurrence of DGE was lower in Braun group (odds ratio [OR], 0.30; 95% confidence interval [CI], 0.15 to 0.60; P = 0.0007). Overall morbidity (OR, 0.61; 95%CI, 0.47 to 0.80; P = 0.0003) and the length of hospital stay (LOS) (weighted mean difference [WMD], -1.80; 95%CI, -3.4 to -0.18; p = 0.03) were also in favor of the Braun group. However, Braun group had no advantage over Non-Braun group in terms of intra-operative blood loss, mortality, pancreatic fistula, bile Leakage and intra-abdominal abscess.

Conclusion: The additional of BEE plays an important role in reducing DGE, overall morbidity and LOS.

Keywords: Braun enteroenterostomy; Delayed gastric emptying; Meta-analysis; Pancreaticoduodenectomy.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Abdominal Abscess / etiology
  • Anastomosis, Surgical / methods
  • Blood Loss, Surgical
  • Enterostomy / methods*
  • Gastroparesis / etiology
  • Gastroparesis / surgery*
  • Humans
  • Length of Stay
  • Pancreatic Fistula / etiology
  • Pancreaticoduodenectomy / adverse effects
  • Treatment Outcome