Related Experiment Video
Updated: May 9, 2026
Modified Single-Loop Reconstruction for Pancreaticoduodenectomy
Published on: September 28, 2019
Does modified Braun enteroenterostomy improve alkaline reflux gastritis and marginal ulcer after
An-Ping Su1, Neng-Wen Ke, Yi Zhang
1Department of Hepatobiliopancreatic Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
Insights
Child reconstruction with a modified Braun enteroenterostomy significantly reduces marginal ulcers after pancreaticoduodenectomy compared to Roux-en-Y. Both methods appear equally effective for alkaline reflux gastritis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Abdominal Surgery
Background:
- Pancreaticoduodenectomy safety has improved.
- Alkaline reflux gastritis and marginal ulcer remain significant post-pancreaticoduodenectomy complications.
Purpose of the Study:
- To compare Child reconstruction with modified Braun enteroenterostomy versus Roux-en-Y reconstruction.
- To determine which method better reduces alkaline reflux gastritis and marginal ulcer incidence.
Main Methods:
- Prospective data collection from 57 patients undergoing pancreaticoduodenectomy (2008-2012).
- Comparison of early and late complications between Child and Roux-en-Y reconstructions.
- Univariate and multivariate analyses to identify risk factors for complications.
Main Results:
- No significant difference in early complications or alkaline reflux gastritis between methods.
- Marginal ulcer incidence was significantly lower with Child reconstruction (11.1%) versus Roux-en-Y (47.6%).
- Later postoperative morbidity and BMI changes differed significantly between groups at 12 months.
Conclusions:
- Child reconstruction with modified Braun enteroenterostomy is advantageous for reducing marginal ulcers post-pancreaticoduodenectomy.
- This modified reconstruction may be as effective as Roux-en-Y for preventing alkaline reflux gastritis.
Background:
The safety of pancreaticoduodenectomy has improved significantly. However, alkaline reflux gastritis and marginal ulcer are two substantial problems after pancreaticoduodenectomy.
Aims:
To identify whether Child reconstruction with a modified Braun enteroenterostomy decreases the incidence of alkaline reflux gastritis and marginal ulcer after pancreaticoduodenectomy better than Roux-en-Y reconstruction.
Methods:
Data on 57 consecutive patients who underwent standard pancreaticoduodenectomy between January 1, 2008 and January 31, 2012 were collected prospectively. Data on early and late complications of the Child reconstruction with a modified Braun enteroenterostomy and Roux-en-Y were gathered. The risk factors of alkaline reflux gastritis and marginal ulcer were also investigated by using univariate and multivariate analyses.
Results:
Twenty-five patients received Roux-en-Y and 32 underwent Child reconstruction with a modified Braun enteroenterostomy. Early complications after the two reconstruction methods were insignificant. Significant differences in terms of later postoperative morbidity (P = 0.01) and change in body mass index (P = 0.03) were found 12 months after pancreaticoduodenectomy. No significant difference for alkaline reflux gastritis was observed between the two methods (14.8 vs. 28.6 %, P = 0.24). Marginal ulcer occurred significantly lower in patients with the modified reconstruction than in those with Roux-en-Y reconstruction (11.1 vs. 47.6 %, P = 0.01). Peptic ulcer history, diabetes mellitus, and reconstruction type had a significant effect on marginal ulcer formation.
Conclusions:
Child reconstruction with a modified Braun enteroenterostomy offers an advantage with respect to marginal ulcer after standard pancreaticoduodenectomy, potentially decreasing the incidence of alkaline reflux gastritis as effectively as Roux-en-Y reconstruction.
Related Concept Videos
01:25Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
01:26Peptic Ulcer Disease IV: Management
The therapeutic approach involves ensuring adequate rest, implementing drug therapy, promoting smoking cessation, making dietary modifications, and emphasizing long-term follow-up care.
Pharmacological management
The prevailing therapy for peptic ulcers involves a combination of managing the patient's current medication...
01:26Endoscopic Procedures V: ERCP
Patient...