• Takatsugu Oida, Kenji Mimatsu, Hisao Kano, Atsushi Kawasaki, Nobutada Fukino, Kazutoshi Kida, Youichi Kuboi, and Sadao Amano.
• Department of Surgery, Social Insurance Yokohama Central Hospital, Yokohama, Japan. ooida.takatsugu@yokochu.jp
• Hepato Gastroenterol. 2012 Jun 1; 59 (116): 1274-6.

Background/AimsPreviously, we developed a modified subtotal stomach-preserving pancreaticoduodenectomy for preventing delayed gastric emptying and achieved a decrease in the incidence of delayed gastric emptying. In this study, we compared the antecolic and retrocolic routes to determine which reconstruction route is better for decreasing the incidence of delayed gastric emptying in modified subtotal stomachpreserving pancreaticoduodenectomy.MethodologyWe retrospectively analyzed 42 patients who underwent modified subtotal stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy. The patients were divided into 2 groups based on type of reconstruction: the antecolic reconstruction group and the retrocolic reconstruction group. The incidence of delayed gastric emptying was determined and compared between the 2 groups.ResultsThe mean time during nasogastric suction and before initiation of a diet after surgery was shorter in the retrocolic reconstruction group (without significant difference); however, the mean time before oral ingestion of solid food could be safely resumed was significantly shorter in the retrocolic reconstruction group (9.7±1.2 days) than in the antecolic reconstruction group AC group (11.4±3.0 days; p<0.0112).ConclusionsWe consider retrocolic reconstruction preferable to antecolic reconstruction for preventing delayed gastric emptying in patients who have undergone modified subtotal-stomach-preserving pancreaticoduodenectomy with pancreaticogastrostomy.

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