Journal article
Braun Enteroenterostomy is Associated With Reduced Delayed Gastric Emptying and Early Resumption of Oral Feeding Following Pancreaticoduodenectomy
Journal of surgical oncology, Vol.101(5), pp.351-355
04/01/2010
DOI: 10.1002/jso.21490
PMID: 20112274
Abstract
Background and Objectives: Morbidity rates following pancreaticoduodenectomy (PD) remain high with delayed gastric emptying (DGE) and slow resumption of oral diet contributing to increased postoperative length of stay. A Braun enteroenterostomy has been shown to decrease bile reflux following gastric resection. We hypothesize that addition of Braun enteroenterostomy during PD would reduce the sequelae of DOE.
Methods: From our PD database, patients were identified that underwent classic PD with partial gastrectomy from 2001 to 2006. All patients with reconstruction utilizing a single loop of jejunum at the University of Florida Shands Hospital were reviewed. Demographics, presenting signs and symptoms, pathologic dint-loses, and postoperative morbidity were compared in those patients undergoing reconstruction with an additional Braun enteroenterostomy (n = 70) to those not undergoing a Braun enteroenterostomy (n = 35).
Results: Patients undergoing a Braun had NO tubes removed earlier (Braun: 2 days, no Braun: 3 days, P = 0.002) and no significant change in postoperative vomiting (Braun: 27%, no Braun: 37%, P = 0.37) or NO tube reinsertion rates (Braun: 17%, no Braun: 29%, P = 0.21). Median postoperative day with tolerance of oral liquids (Braun: 5, no Braun: 6, P = 0.01) and solid diets (Braun: 7, no Braun: 9, P = 0.01) were significantly sooner in the Braun group. DOE defined by two criteria including the inability to have oral intake by postoperative day 10 (Braun: 10%, no Braun: 26%, P < 0.05) and the international grading criteria (grades B and C, Braun: 7% vs. no Braun: 31%, P = 0.003) were significantly reduced in those undergoing the Braun procedure. In addition, the median length of stay (Braun: 10 days, no Braun: 12 days, P < 0.05) was significantly reduced in those undergoing the Braun procedure. The rate of pancreatic anastomotic failure was similar in the two groups (Braun: 17% vs. no Braun: 14%, P = 0.79). Median bile reflux was 0% in those undergoing a Braun.
Conclusions: The present study suggests that Braun enteroenterostomy can be safely performed in patients undergoing PD and may reduce the indicence of DOE and its sequelae. Further studies of Braun enteroenterostomy in larger randomized trials of patients undergoing PD are warranted. J. Surg. Oncol. 2010:101:351-355. (C) 2010 Wiley-Liss, Inc.
Details
- Title: Subtitle
- Braun Enteroenterostomy is Associated With Reduced Delayed Gastric Emptying and Early Resumption of Oral Feeding Following Pancreaticoduodenectomy
- Creators
- Steven N. Hochwald - University of Florida HealthStephen R. Grobmyer - University of Florida Health Science CenterAlan W. Hemming - University of Florida HealthEleanor Curran - University of Florida HealthDavid A. Bloom - University of Florida HealthMatthew Delano - University of Florida HealthKevin E. Behrns - University of Florida HealthEdward M. Copeland - University of Florida HealthStephen B. Vogel - University of Florida Health
- Resource Type
- Journal article
- Publication Details
- Journal of surgical oncology, Vol.101(5), pp.351-355
- Publisher
- Wiley
- DOI
- 10.1002/jso.21490
- PMID
- 20112274
- ISSN
- 0022-4790
- eISSN
- 1096-9098
- Number of pages
- 5
- Language
- English
- Date published
- 04/01/2010
- Academic Unit
- Surgery
- Record Identifier
- 9984322818102771
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