Delayed gastric emptying is associated with pylorus-preserving but not classical Whipple pancreaticoduodenectomy: A review of the literature and critical reappraisal of the implicated pathomechanism

摘要: Pylorus-preserving pancreaticoduodenectomy (PPPD) is nowadays considered the treatment of choice for periampullary tumors, namely carcinoma head, neck, or uncinate process pancreas, ampulla Vater, distal common bile duct peri-Vaterian duodenum. Delayed gastric emptying (DGE) comprises one most troublesome complications this procedure. A search literature using Pubmed/Medline was performed to identify clinical trials examining incidence rate DGE following standard Whipple (PD) vs PPPD. Additionally we a thorough in-depth analysis implicated pathomechanism underlying occurrence after In contrast early studies, majority recently demonstrated no significant association between with either PD and PPPD procedures are equally effective operations regarding postoperative DGE. Further randomized required investigate efficacy reported (but not yet tested in large-scale studies) modification, that is, antecolic duodenojejunostomy.