Document Type : Original Article
Authors
1
Surgery department, Jondishapor university of medical science, Ahvaz, Iran
2
Surgery department, jundishapur univercity of medical sciences, Ahvaz, Iran
3
Surgery department, Jundishapur univercity of medical sciences, Ahvaz, Iran
10.22118/jjo.2021.265124.1006
Abstract
Background: delayed gastric emptying (DGE) after whipple is a common problem. The aim of this study was to compare the efficacy of right to left (R-to-L) (iso-peristaltic anastomosis) gastrojejunostomy versus left to right (L-to-R) (anti-peristaltic anastomosis) in delayed gastric emptying after whipple.
Materials & Methods: this clinical trial, 60 patients referred to Golestan and Arvand Hospital in Ahvaz who needed Pancreaticoduodenectomy (PD), entered the study and were divided into two groups. The first group underwent gastrojejunostomy with iso-peristaltic as R-to-L anastomosis and the second group underwent anti-peristaltic as L-to-R anastomosis. The two groups were compared in one month after surgery for DGE severity, NPO duration, hospital stay duration, TPN requirement and re-hospitalization requirement.
Results: DGE intensity in R-to-L decreased significantly compared to L-to-R (intensity: 16.7% versus 43.5%, P <0.001. Intensity: grade A = 10 ٪, grade B = 6.7 ٪, grade C = 0 ٪ versus A = 20 ٪, B = 13.3 ٪, C = 10 ٪,. (P <0.001) NPO duration and duration of hospitalization in R-L were significantly lower than L-R (NPO: 3.1 vs. 4.7, P = 0.028; HSP: 4.3 vs. 7.8, (P = 003. The re-hospitalization rate in R-L was lower than in the other group (3% vs. 26.7%, P <0.001). None of the R-L patients required TPN, but 16.7% of the L-R group required TPN, which was a significant difference (P <0.001).
Conclusion: It seems that the use of R-to-L gastrojejunostomy significantly reduces the delay in gastric emptying after the Whipple operation for a periampullary tumor
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