Pylorus Preserving Pancreaticoduodenectomy with Low Incidence of Early Delayed Gastric Emptying
Suvit Sriussadaporn MD*, Supparerk Prichayudh MD*, Sukanya Sriussadaporn MD*, Kritaya Kritayakirana MD*, Rattaplee Pak-art MD*
Affiliation : * Department of Surgery, Faculty of Medicine, Chulalongkorn University
Background and
Objective : Early delayed gastric emptying (early DGE) is a common complication after
pylorus-preserving pancreaticoduodenectomy (PPPD). The authors studied the occurrence of early DGE in
the presented patients. The explanation of authors’ results was discussed and a brief literature review was
performed.
Materials and Methods : The occurrence of early DGE was studied in 37 patients with periampullary neoplasms
or other benign conditions who underwent PPPD between from April 1992 and March 2006. The operations
were performed by the first author with uniform surgical techniques. After the year 2000, an external pancreatic
stent was routinely inserted into the pancreatic duct during pancreaticojejunostomy anastomosis.
Results : Early DGE occurred in two patients (5.4%), one in the non-stented and one in the stented group. Two
patients had pancreatic fistula and two had wound infection. The overall morbidity rate was 16.2%. There
was no re-operation or intra-abdominal abscess requiring drainage or mortality in the present study.
Conclusions : The occurrence of early DGE after PPPD may be lessened by strict awareness and avoidance of
complications associated with PPPD. Surgical experiences with faultless and meticulous surgical techniques
are important for lowering such complications.
Keywords : Early delayed gastric emptying, Pylorus preserving pancreaticoduodenectomy
