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Horizontal vs. vertical incision on the anterior gastric wall in pancreaticogastrostomy
Takatsugu Oida1, Kenji Mimatsu, Hisao Kano
1Department of Surgery, Yokohama Central Hospital, Yokohama, Japan.
Background/Aims:
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 pancreaticogastrostomy.
Methodology:
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).
Results:
The observed grade of delayed gastric emptying was lower in the V group than in the H group; however, the difference was not significant.
Conclusions:
We conclude that a vertical incision on the anterior gastric wall is preferable for preventing delayed gastric emptying after a pancreaticogastrostomy.
