Source:Journal of the American College of Surgeons
Author(s): Adeel S. Khan, Greg Williams, Cheryl Woolsey, Jingxia Liu, Ryan C. Fields, Majella MB. Doyle, William G. Hawkins, Steven M. Strasberg
IntroductionDelayed gastric emptying (DGE) is a common serious problem after pancreatoduodenectomy (PD). Flange gastrojejunostomy (FL-GE) is a previously described technique that creates an internal flange in a hand sewn gastroenterostomy. Results of FL-GE on incidence and severity of DGE after PD are presented.MethodsData were extracted from a prospective database of PD. Standard PD with antrectomy were performed –with Flange Gastroenterostomy (FL-GE) or other techniques (NonFL-GE) at a single institution. International Study Group (ISGPS) definition of DGE was used and DGE severity was graded based on ISGPS grading system and the Modified Accordion Grading System (MAGS).Results215 standard PDs were performed. 68 (32%) were FL-GE and 147 (68%) were NonFL-GE. DGE rates in FL-GE and NonFL-GE were 9% and 23% respectively (p=0.012). The differences in severity of DGE were even more prominent. 29% of DGEs in NonFL-GE group were ISGPS grade C versus 0% in FL-GE. Also, 35% of DGEs in NonFL-GE group were MAGS3 versus 0% in FL-GE. Because of some differences in sex and inflammatory complications between groups, a propensity score analysis was performed creating 57 matched patients in FL-GE and NonFL-GE groups. DGE incidence remained significantly different in the groups: 5% in FL-GE vs. 18% in NonFL-GE; p=0.039).ConclusionIn this cohort study, the Flange technique was associated with a marked reduction in the incidence of DGE after PD.
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Flange gastroenterostomy is associated with reduced incidence of delayed gastric emptying after standard pancreatoduodenectomy.from #ENT-AlexandrosSfakianakis via ola Kala on Inoreader http://ift.tt/2so65tg
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