scholarly journals Risk factors for post‐pancreaticoduodenectomy delayed gastric emptying in the absence of pancreatic fistula or intra‐abdominal infection

2019 ◽  
Vol 119 (7) ◽  
pp. 925-931 ◽  
Author(s):  
Ryan J. Ellis ◽  
Aakash R. Gupta ◽  
D. Brock Hewitt ◽  
Ryan P. Merkow ◽  
Mark E. Cohen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying ◽  
Abdominal Infection ◽  
Intra Abdominal Infection

Risk Factors of Pancreatic Fistula and Delayed Gastric Emptying after Pancreaticoduodenectomy with Pancreaticogastrostomy

2007 ◽  
Vol 204 (4) ◽  
pp. 588-596 ◽  
Author(s):  
Emilie Lermite ◽  
Patrick Pessaux ◽  
Olivier Brehant ◽  
Carlos Teyssedou ◽  
Isabelle Pelletier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying

scholarly journals Comparison of surgical outcomes between isolated pancreaticojejunostomy, isolated gastrojejunostomy, and conventional pancreaticojejunostomy after pancreaticoduodenectomy: A systematic review and meta-analysis

2020 ◽  
Author(s):  
lyu yunxiao ◽  
Bin Wang ◽  
Yunxiao Cheng ◽  
Yueming Xu ◽  
WeiBing Du
Keyword(s):  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying ◽  
Operation Time ◽  
Major Complication ◽  
Bile Leakage ◽  
Postoperative Pancreatic Fistula ◽  
Controlled Trials ◽  
Cochrane Central Register ◽  
Major Complications

Abstract Background We aimed to compare the safety and effectiveness of the following procedures after pancreaticoduodenectomy: isolated pancreaticojejunostomy, isolated gastrojejunostomy, and conventional pancreaticojejunostomy. Methods We performed a systematic search of the following databases: PubMed, Embase, Web of Science, the Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov until 1 January 2020. Pooled odds ratios (OR) or weighted mean differences (WMD) with 95% confidence intervals (CIs) were calculated using STATA 12.0 statistical software.Results Thirteen studies involving 1942 patients were included in this study. Pooled analysis showed that the major complication and reoperation rates following isolated pancreaticojejunostomy were lower than with conventional pancreaticojejunostomy (OR=0.35, 95% CI: 0.13–0.96, P=0.04 and OR=0.36, 95% CI: 0.15–0.86, p=0.02, respectively), and that isolated pancreaticojejunostomy required longer operation time vs conventional pancreaticojejunostomy (WMD=43.61, 95% CI: 21.64–65.58, P=0.00). Regarding postoperative pancreatic fistula, clinically-relevant postoperative pancreatic fistula, delayed gastric emptying, clinically-relevant delayed gastric emptying, bile leakage, hemorrhage , reoperation, length of postoperative hospital stay, major complications, overall complications, and mortality, we found no significant differences for either isolated pancreaticojejunostomy versus conventional pancreaticojejunostomy or isolated gastrojejunostomy versus conventional pancreaticojejunostomy. Conclusions This study showed that isolated pancreaticojejunostomy was associated with fewer major complications and a lower reoperation rate, but required longer operation time vs conventional pancreaticojejunostomy. Considering the limitations, high-quality randomized controlled trials are required.

scholarly journals Delayed gastric emptying after pancreatoduodenectomy: comparison between two different pancreatic reconstruction techniques

2019 ◽  
Author(s):  
Satoshi Hayama ◽  
N Senmaru ◽  
Satoshi Hirano
Keyword(s):  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying ◽  
Frequent Occurrence ◽  
Reconstruction Technique ◽  
Similar Frequency ◽  
Abdominal Complications ◽  
Factors Associated ◽  
Pancreatic Reconstruction

Abstract Background The association between delayed gastric emptying (DGE) after pancreatoduodenectomy (PD) and pancreatic reconstruction technique remain unclear. The aim of this study is to investigate whether the occurrence of DGE differs between pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG). Methods A total of 83 patients who underwent subtotal stomach-preserving pancreatoduodenectomy was retrospectively analyzed, and the factors associated with clinically relevant DGE were explored. These patients were divided into a PG group and a PJ group according to the pancreatic reconstruction. DGE occurrence and its association with intra-abdominal complications was compared between the two types of pancreatic reconstruction. Results The overall incidence of DGE was 27.7%. Intra-abdominal complications including pancreatic fistula were strongly associated with DGE. As to the pancreatic reconstruction, DGE developed more frequently in the PG than in the PJ. In addition, DGE with intra-abdominal complications tended to be more frequent in PG, despite the fact that intra-abdominal complications occurred at a similar frequency in both groups. Conclusions Intra-abdominal complications were strongly associated with DGE. As to the pancreatic reconstruction, DGE developed more frequently in the PG than in the PJ. We speculate that intra-abdominal complications affected patients with PG more and resulted in frequent occurrence of DGE.

Patients with Risk Factors for Complications Do Not Require Longer Antimicrobial Therapy for Complicated Intra-Abdominal Infection

2016 ◽  
Vol 82 (9) ◽  
pp. 860-866 ◽  
Author(s):  
Rishi Rattan ◽  
Casey J. Allen ◽  
Robert G. Sawyer ◽  
John Mazuski ◽  
Therese M. Duane ◽  
...  
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Surgical Site Infection ◽  
Chronic Health Evaluation ◽  
Health Evaluation ◽  
Site Infection ◽  
Chronic Health ◽  
Abdominal Infection ◽  
Short Course ◽  
Intra Abdominal Infection

A prospective, multicenter, randomized controlled trial found that four days of antibiotics for source-controlled complicated intra-abdominal infection resulted in similar outcomes when compared with a longer duration. We hypothesized that patients with specific risk factors for complications also had similar outcomes. Short-course patients with obesity, diabetes, or Acute Physiology and Chronic Health Evaluation II ≥15 from the STOP-IT trial were compared with longer duration patients. Outcomes included incidence of and days to infectious complications, mortality, and length of stay. Obese and diabetic patients had similar incidences of and days to surgical site infection, recurrent intra-abdominal infection, extra-abdominal infection, and Clostridium difficile infection. Short- and long-course patients had similar incidences of complications among patients with Acute Physiology and Chronic Health Evaluation II ≥15. However, there were fewer days to the diagnosis of surgical site infection (9.5 ± 3.4 vs 21.6 ± 6.2, P = 0.010) and extra-abdominal infection (12.4 ± 6.9 vs 21.8 ± 6.1, P = 0.029) in the short-course group. Mortality and length of stay was similar for all groups. A short course of antibiotics in complicated intraabdominal infection with source control seems to have similar outcomes to a longer course in patients with diabetes, obesity, or increased severity of illness.

scholarly journals A technique for decreasing delayed gastric emptying in the setting of pancreatic fistula

HPB ◽  
2018 ◽  
Vol 20 ◽  
pp. S841-S842
Author(s):  
B.A. Sayed ◽  
C.A. Moulton ◽  
P. Greig ◽  
I. McGilvray ◽  
S. Gallinger ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying

Pancreatic Fistula and Delayed Gastric Emptying Are the Highest-Impact Complications After Whipple

2020 ◽  
Vol 250 ◽  
pp. 80-87 ◽  
Author(s):  
Jennifer A. Mirrielees ◽  
Sharon M. Weber ◽  
Daniel E. Abbott ◽  
Caprice C. Greenberg ◽  
Rebecca M. Minter ◽  
...  
Keyword(s):  
Gastric Emptying ◽  
Pancreatic Fistula ◽  
Delayed Gastric Emptying
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