Subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) prevents postoperative delayed gastric emptying

J Surg Oncol. 2010 Nov 1;102(6):615-9. doi: 10.1002/jso.21687.

Abstract

Background and objectives: Delayed gastric emptying (DGE) is one of main complications after pylorus-preserving pancreaticoduodenectomy (PPPD) with regional lymph node dissection (RLND). The aim of this study was to retrospectively investigate whether subtotal stomach-preserving PD (SSPPD) decreased incidence of DGE.

Methods: This study included 112 consecutive patients underwent PPPD (n = 48) or SSPPD (n = 64) with/without RLND. DGE was classified into three categories (grades A, B, and C) according to the guideline proposed by the International Study Group of Pancreatic Surgery.

Results: The incidence of DGE grade B/C in SSPPD with RLND (13.0%) was lower compared with that (34.8%) in PPPD with RLND (P = 0.0326). Consequently, the mean length of postoperative hospital stay of SSPPD with RLND group was significantly shorter than that of PPPD with RLND (P = 0.0476).

Conclusions: SSPPD could be substituted for PPPD due to decreased postoperative DGE when RLND is involved. A randomized control trial of SSPPD versus PPPD should be considered.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Gastric Emptying*
  • Humans
  • Lymph Node Excision
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods*
  • Plastic Surgery Procedures
  • Postoperative Complications / prevention & control*
  • Pylorus / surgery*