Impact of the Reconstruction Method on Delayed Gastric Emptying After Pylorus‐Preserving Pancreaticoduodenectomy: A Prospective Randomized Study

Abstract

Antecolic reconstruction after PPPD does not improve the occurrence/the incidence of DGE and is similar to retrocolic reconstruction with regard to secondary outcome parameters.

Effect of Antecolic versus Retrocolic Gastroenteric Reconstruction after Pancreaticoduodenectomy on Delayed Gastric Emptying: A Meta-Analysis of Six Randomized Controlled Trials

“…As the data were not available from the authors, these studies were not included in the subgroup analysis [20,21] . Figures were missing for DGE after ppPD in 3 studies including cPD and ppPD [16,18,19] .…”

“…The study by Tamandl et al [20] published in 2014 and performed in a single high-volume center in Austria compared 36 patients with antecolic reconstruction with 28 patients with retrocolic reconstruction after ppPD (Jadad score: 1). Eligible patients were adults between 18 and 90 years undergoing a PD for benign tumor or cancer.…”

“…Information from one study [16] was collected via the authors; the 2 other articles were not included in the ppPD subgroup meta-analysis [18,19] . Three studies described the length of hospital stay as median and not as mean [16,20,22] . For 2 studies, the mean was obtained from the authors [16,22] .…”

“…Two studies had no subdivision of DGE described in their manuscript [20,21] . As the data were not available from the authors, these studies were not included in the subgroup analysis [20,21] .…”

“…Since the available evidence remains conflicting, there is an ongoing debate as to whether an antecolic or retrocolic (through the mesocolon) reconstruction should be favored. Some retrospective studies and randomized controlled trials (RCTs) have shown that the antecolic method is associated with fewer DGE [15,17,18,21,26] , but other studies found no difference [16,19,20,22,23] . Three specific meta-analyses were performed: two concluding that the antecolic reconstruction was superior [25,27] and one finding that there was no difference [28] .…”