The effect of antecolic versus retrocolic reconstruction on delayed gastric emptying after classic non–pylorus-preserving pancreaticoduodenectomy

Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy

“…However, the impact of ante-or retrocolic reconstruction on DGE is still under debate. 29,30 Differences in baseline characteristics are also possible, as the Asian populations had lower BMI than the population of the PROPP study. Unfortunately, BMI was not reported in the RCT of Kawai et al 15 However, the preoperative weight of the Kawai cohort was reported as 55 AE 10 kg, compared with 76.5 AE 15.1 kg in the current RCT.…”

The impact of intraoperative goal-directed fluid therapy on complications after pancreaticoduodenectomy

“…Improvements in the pancreatico-jejunal anastomotic technique and utilization of a round ligament flap or omental wrappings have shown some benefit in reducing pancreatic leak [ [7] , [8] , [9] ]. Modifications of the enteric anastomosis have yielded some modest improvements in the rate of delayed gastric emptying [ 10 ]. Patient outcomes have been favorably impacted by initiatives to perform these complex procedures at high-volume centers, as well as advances in minimally-invasive techniques, which have gradually been incorporated into surgical practice [ 11 , 12 ].…”

Antecolic reconstruction is associated with a lower incidence of delayed gastric emptying compared to retrocolic technique after Whipple or pylorus-preserving pancreaticoduodenectomy

“…Of these, 5 studies, in which mixed groups of surgeries were reported and from which data could not be extracted separately and 2 meta-analysis studies were excluded. Finally, in total, 15 [14,16,24–36] studies met our inclusion criteria and were retrieved for more detailed evaluation.…”