Horizontal vs. vertical incision on the anterior gastric wall in pancreaticogastrostomy

Takatsugu Oida, Kenji Mimatsu, Hisao Kano, Atsushi Kawasaki, Youichi Kuboi, Nobutada Fukino, Kazutosi Kida, Sadao Amano
Hepato-Gastroenterology  
Pancreaticogastrostomy during pancreaticoduodenectomy is associated with a very low rate of anastomotic leakage. However, gastric peristalsis is disturbed by pancreaticogastrostomy, which stabilizes the posterior stomach at that point leading to delayed gastric emptying. We evaluated which anterior gastrostomy, i.e. horizontal or vertical incision on the anterior gastric wall, is better for maintaining peristaltic movement of the anterior stomach to prevent delayed gastric emptying after
more » ... ptying after pancreaticogastrostomy. We retrospectively studied 50 patients who underwent subtotal stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy. These patients were divided into 2 groups depending on the type of anterior gastrostomy: horizontal incision (H group) and vertical incision (V group). The observed grade of delayed gastric emptying was lower in the V group than in the H group; however, the difference was not significant. We conclude that a vertical incision on the anterior gastric wall is preferable for preventing delayed gastric emptying after a pancreaticogastrostomy.
doi:10.5754/hge10579 pmid:23178628 fatcat:ekmap4wcpnhltbg7ncd74p7pwy