Comparison on Effectiveness of Antecolic Duodenojejunostomy and Retrocolic Duodenojejunostomy after Pylorus-Preserving Pancreaticoduodenectomy: A Meta-Analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 XUMing , SHENHuo-jian , ZHUHong-yi , YANGChao , SHIWei-jin ,  JIFu

Department of Biliary-Pancreatic Surgery, Ren Ji Hospital, School of Medcine, Shanghai Jiao Tong University, Shanghai 200127, China;

Corresponding author：

JIFu, Email: jifu1323@163.com

Keywords：

Pylorus-preserving pancreaticoduodenectomy; Duodenojejunostomy; Delayed gastric emptying; Meta analysis

DOI：

10.7507/1007-9424.20140362

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To compare the effectiveness of antecolic duodenojejunostomy (ADJ) and retrocolic duodenojejunostomy (RDJ) after pylorus-preserving pancreaticoduodenectomy (PPPD). Methods Randomized controlled trials (RCTs) of ADJ versus RDJ after PPPD were searched in Cochrane Library, PubMed database, Embase database, Web of Science, Chinese biomedicine database, CNKI database, VIP database, and Wanfang database from inception to April 2014, as well as Google. After quality assessment of RCTs according to the Cochrane Handbook for Systematic Reviews of Interventions Version, Meta analysis was performed by RevMan 5.1 software. Results Four RCTs of 462 patients in total were included in this Meta-analysis. The results of Meta-analysis showed that, there were no significant differences in the operation time (MD=14.02, 95% CI:-41.42-69.46, P=0.62), incidence of postoperative complications (RR=1.09, 95% CI:0.81-1.48, P=0.56), incidence of delayed gastric emptying (RR=0.63, 95% CI:0.31-1.28, P=0.20), incidence of pancreatic fistula (RR=1.13, 95% CI:0.72-1.75, P=0.60), incidence of abdominal abscess (RR=0.92, 95% CI:0.54-1.58, P=0.77), and mortality (RR=0.61, 95% CI:0.24-1.60, P=0.32) between ADJ group and RDJ group. Conclusions The effectiveness of ADJ is similar with RDJ after PPPD, so the reconstruction way after PPPD can be routed according to the surgeon's preference.

Citation： XUMing, SHENHuo-jian, ZHUHong-yi, YANGChao, SHIWei-jin, JIFu. Comparison on Effectiveness of Antecolic Duodenojejunostomy and Retrocolic Duodenojejunostomy after Pylorus-Preserving Pancreaticoduodenectomy: A Meta-Analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(12): 1537-1543. doi: 10.7507/1007-9424.20140362 Copy

1.	Traverso LW,Longmire WP Jr.Preservation of the pylorus in pancreaticoduodenectomy[J].Surg Gynecol Obstet,1978,146(6):959-962.
2.	Friess H,Kleeff J,Fischer L,et al.Surgical standard therapy for cancer of the pancreas[J].Chirurg,2003,74(3):183-190.
3.	Leichtle SW,Kaoutzanis C,Mouawad NJ,et al.Classic Whipple versus pylorus-preserving pancreaticoduodenectomy in the ACS NSQIP[J].J Surg Res,2013,183(1):170-176.
4.	Park YC,Kim SW,Jang JY,et al.Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy[J].J Am Coll Surg,2003,196(6):859-865.
5.	Lytras D,Paraskevas KI,Avgerinos C,et al.Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection[J].Langenbecks Arch Surg,2007,392(1):1-12.
6.	Welsch T,Borm M,Degrate L,et al.Evaluation of the International Study Group of Pancreatic Surgery definition of delayed gastric emptying after pancreatoduodenectomy in a high-volume centre[J].Br J Surg,2010,97(7):1043-1050.
7.	Akizuki E,Kimura Y,Nobuoka T,et al.Reconsideration of postoperative oral intake tolerance after pancreaticoduodenectomy:prospective consecutive analysis of delayed gastric emptying according to the ISGPS definition and the amount of dietary intake[J].Ann Surg,2009,249(6):986-994.
8.	Bassi C,Falconi M,Molinari E,et al.Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy:results of a comparative study[J].Ann Surg,2005,242(6):767-771.
9.	Kimura F,Suwa T,Sugiura T,et al.Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy[J].Hepatogastroenterology,2002,49(44):585-588.
10.	Tani M,Terasawa H,Kawai M,et al.Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy:results of a prospective,randomized,controlled trial[J].Ann Surg,2006,243(3):316-320.
11.	Kurosaki I,Hatakeyama K.Clinical and surgical factors influencing delayed gastric emptying after pyloric-preserving pancreaticoduodenectomy[J].Hepatogastroenterology,2005,52(61):143-148.
12.	Murakami Y,Uemura K,Sudo T,et al.An antecolic Roux-en-Y type reconstruction decreased delayed gastric emptying after pylorus-preserving pancreatoduodenectomy[J].J Gastrointest Surg,2008,12(6):1081-1086.
13.	Hartel M,Wente MN,Hinz U,et al.Effect of antecolic reconstruction on delayed gastric emptying after the pylorus-preserving Whipple procedure[J].Arch Surg,2005,140(11):1094-1099.
14.	Eshuis WJ,van Dalen JW,Busch OR,et al.Route of gastroenteric reconstruction in pancreatoduodenectomy and delayed gastric emptying[J].HPB (Oxford),2012,14(1):54-59.
15.	Chijiiwa K,Imamura N,Ohuchida J,et al.Prospective rando-mized controlled study of gastric emptying assessed by C-13-acetate breath test after pylorus-preserving pancreaticoduodenectomy:comparison between antecolic and vertical retrocolic duodenojeju-nostomy[J].J Hepatobiliary Pancreat Surg,2009,16(1):49-55.
16.	Gangavatiker R,Pal S,Javed A,et al.Effect of antecolic or retrocolic reconstruction of the gastro/duodenojejunostomy on delayed gastric emptying after pancreaticoduodenectomy:a rando-mized controlled trial[J].J Gastrointest Surg,2011,15(5):843-852.
17.	陈创奇,詹文华.保留幽门胰十二指肠切除术的研究进展[J].国外医学:外科学分册,2001,28(3):154-156.
18.	Wente MN,Bassi C,Dervenis C,et al.Delayed gastric emptying (DGE) after pancreatic surgery:a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)[J].Surgery,2007,142(5):761-768.
19.	Higgins J,Green S.Cochrane handbook for systematic reviews of interventions Version 5.1.0[S].2013-4-20.www.cochrane-handbook.org.
20.	Imamura N,Chijiiwa K,Ohuchida J,et al.Prospective randomized clinical trial of a change in gastric emptying and nutritional status after a pylorus-preserving pancreaticoduodenectomy:comparison between an antecolic and a vertical retrocolic duodenojejunostomy[J].HPB (Oxford),2014,16(4):384-394.
21.	Tamandl D,Sahora K,Prucker J,et al.Impact of the reconstruc-tion method on delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy:a prospective randomized study[J].World J Surg,2014,38(2):465-475.
22.	Eshuis WJ,van Eijck CH,Gerhards MF,et al.Antecolic versus retrocolic route of the gastroenteric anastomosis after pancreatoduodenectomy:a randomized controlled trial[J].Ann Surg,2014,259(1):45-51.
23.	Watson K.Carcinoma of ampulla of vater:successful radical resection[J].Br J Surg,1944,31:368-383.
24.	Kurosaki I,Hatakeyama K.Preservation of the left gastric vein in delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy[J].J Gastrointest Surg,2005,9(6):846-852.
25.	Malleo G,Crippa S,Butturini G,et al.Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy:validation of International Study Group of Pancreatic Surgery classification and analysis of risk factors[J].HPB (Oxford),2010,12(9):610-618.
26.	Qu H,Sun GR,Zhou SQ,et al.Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy:a systematic review and meta-analysis[J].Eur J Surg Oncol,2013,39(3):213-223.
27.	Hochwald SN,Grobmyer SR,Hemming AW,et al.Braun enteroenterostomy is associated with reduced delayed gastric emptying and early resumption of oral feeding following pancreaticoduodenectomy[J].J Surg Oncol,2010,101(5):351-355.
28.	Sakamoto Y,Yamamoto Y,Hata S,et al.Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions[J].J Gastrointest Surg,2011,15(10):1789-1797.
29.	Kollmar O,Sperling J,Moussavian MR,et al.Delayed gastric emptying after pancreaticoduodenectomy:influence of the orthotopic technique of reconstruction and intestinal motilin receptor expression[J].J Gastrointest Surg,2011,15(7):1158-1167.
30.	Traverso LW,Hashimoto Y.Delayed gastric emptying:the state of the highest level of evidence[J].J Hepatobiliary Pancreat Surg,2008,15(3):262-269.
31.	Horstmann O,Markus PM,Ghadimi MB,et al.Pylorus preservation has no impact on delayed gastric emptying after pancreatic head resection[J].Pancreas,2004,28(1):69-74.
32.	高红桥,杨尹默,庄岩,等.保留幽门胰十二指肠切除术后发生胃排空延迟的影响因素分析[J].中华外科杂志,2007,45(15):1048-1051.
33.	Khan AS,Hawkins WG,Linehan DC.A technique of gastrojejunostomy to reduce delayed gastric emptying after pancreatoduodenectomy[J].J Gastrointest Surg,2011,15(8):1468-1471.
34.	Su AP,Cao SS,Zhang Y,et al.Does antecolic reconstruction for duodenojejunostomy improve delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy? A systematic review and meta-analysis[J].World J Gastroenterol,2012,18(43):6315-6323.

1. Traverso LW,Longmire WP Jr.Preservation of the pylorus in pancreaticoduodenectomy[J].Surg Gynecol Obstet,1978,146(6):959-962.
2. Friess H,Kleeff J,Fischer L,et al.Surgical standard therapy for cancer of the pancreas[J].Chirurg,2003,74(3):183-190.
3. Leichtle SW,Kaoutzanis C,Mouawad NJ,et al.Classic Whipple versus pylorus-preserving pancreaticoduodenectomy in the ACS NSQIP[J].J Surg Res,2013,183(1):170-176.
4. Park YC,Kim SW,Jang JY,et al.Factors influencing delayed gastric emptying after pylorus-preserving pancreatoduodenectomy[J].J Am Coll Surg,2003,196(6):859-865.
5. Lytras D,Paraskevas KI,Avgerinos C,et al.Therapeutic strategies for the management of delayed gastric emptying after pancreatic resection[J].Langenbecks Arch Surg,2007,392(1):1-12.
6. Welsch T,Borm M,Degrate L,et al.Evaluation of the International Study Group of Pancreatic Surgery definition of delayed gastric emptying after pancreatoduodenectomy in a high-volume centre[J].Br J Surg,2010,97(7):1043-1050.
7. Akizuki E,Kimura Y,Nobuoka T,et al.Reconsideration of postoperative oral intake tolerance after pancreaticoduodenectomy:prospective consecutive analysis of delayed gastric emptying according to the ISGPS definition and the amount of dietary intake[J].Ann Surg,2009,249(6):986-994.
8. Bassi C,Falconi M,Molinari E,et al.Reconstruction by pancreaticojejunostomy versus pancreaticogastrostomy following pancreatectomy:results of a comparative study[J].Ann Surg,2005,242(6):767-771.
9. Kimura F,Suwa T,Sugiura T,et al.Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy[J].Hepatogastroenterology,2002,49(44):585-588.
10. Tani M,Terasawa H,Kawai M,et al.Improvement of delayed gastric emptying in pylorus-preserving pancreaticoduodenectomy:results of a prospective,randomized,controlled trial[J].Ann Surg,2006,243(3):316-320.
11. Kurosaki I,Hatakeyama K.Clinical and surgical factors influencing delayed gastric emptying after pyloric-preserving pancreaticoduodenectomy[J].Hepatogastroenterology,2005,52(61):143-148.
12. Murakami Y,Uemura K,Sudo T,et al.An antecolic Roux-en-Y type reconstruction decreased delayed gastric emptying after pylorus-preserving pancreatoduodenectomy[J].J Gastrointest Surg,2008,12(6):1081-1086.
13. Hartel M,Wente MN,Hinz U,et al.Effect of antecolic reconstruction on delayed gastric emptying after the pylorus-preserving Whipple procedure[J].Arch Surg,2005,140(11):1094-1099.
14. Eshuis WJ,van Dalen JW,Busch OR,et al.Route of gastroenteric reconstruction in pancreatoduodenectomy and delayed gastric emptying[J].HPB (Oxford),2012,14(1):54-59.
15. Chijiiwa K,Imamura N,Ohuchida J,et al.Prospective rando-mized controlled study of gastric emptying assessed by C-13-acetate breath test after pylorus-preserving pancreaticoduodenectomy:comparison between antecolic and vertical retrocolic duodenojeju-nostomy[J].J Hepatobiliary Pancreat Surg,2009,16(1):49-55.
16. Gangavatiker R,Pal S,Javed A,et al.Effect of antecolic or retrocolic reconstruction of the gastro/duodenojejunostomy on delayed gastric emptying after pancreaticoduodenectomy:a rando-mized controlled trial[J].J Gastrointest Surg,2011,15(5):843-852.
17. 陈创奇,詹文华.保留幽门胰十二指肠切除术的研究进展[J].国外医学:外科学分册,2001,28(3):154-156.
18. Wente MN,Bassi C,Dervenis C,et al.Delayed gastric emptying (DGE) after pancreatic surgery:a suggested definition by the International Study Group of Pancreatic Surgery (ISGPS)[J].Surgery,2007,142(5):761-768.
19. Higgins J,Green S.Cochrane handbook for systematic reviews of interventions Version 5.1.0[S].2013-4-20.www.cochrane-handbook.org.
20. Imamura N,Chijiiwa K,Ohuchida J,et al.Prospective randomized clinical trial of a change in gastric emptying and nutritional status after a pylorus-preserving pancreaticoduodenectomy:comparison between an antecolic and a vertical retrocolic duodenojejunostomy[J].HPB (Oxford),2014,16(4):384-394.
21. Tamandl D,Sahora K,Prucker J,et al.Impact of the reconstruc-tion method on delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy:a prospective randomized study[J].World J Surg,2014,38(2):465-475.
22. Eshuis WJ,van Eijck CH,Gerhards MF,et al.Antecolic versus retrocolic route of the gastroenteric anastomosis after pancreatoduodenectomy:a randomized controlled trial[J].Ann Surg,2014,259(1):45-51.
23. Watson K.Carcinoma of ampulla of vater:successful radical resection[J].Br J Surg,1944,31:368-383.
24. Kurosaki I,Hatakeyama K.Preservation of the left gastric vein in delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy[J].J Gastrointest Surg,2005,9(6):846-852.
25. Malleo G,Crippa S,Butturini G,et al.Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy:validation of International Study Group of Pancreatic Surgery classification and analysis of risk factors[J].HPB (Oxford),2010,12(9):610-618.
26. Qu H,Sun GR,Zhou SQ,et al.Clinical risk factors of delayed gastric emptying in patients after pancreaticoduodenectomy:a systematic review and meta-analysis[J].Eur J Surg Oncol,2013,39(3):213-223.
27. Hochwald SN,Grobmyer SR,Hemming AW,et al.Braun enteroenterostomy is associated with reduced delayed gastric emptying and early resumption of oral feeding following pancreaticoduodenectomy[J].J Surg Oncol,2010,101(5):351-355.
28. Sakamoto Y,Yamamoto Y,Hata S,et al.Analysis of risk factors for delayed gastric emptying (DGE) after 387 pancreaticoduodenectomies with usage of 70 stapled reconstructions[J].J Gastrointest Surg,2011,15(10):1789-1797.
29. Kollmar O,Sperling J,Moussavian MR,et al.Delayed gastric emptying after pancreaticoduodenectomy:influence of the orthotopic technique of reconstruction and intestinal motilin receptor expression[J].J Gastrointest Surg,2011,15(7):1158-1167.
30. Traverso LW,Hashimoto Y.Delayed gastric emptying:the state of the highest level of evidence[J].J Hepatobiliary Pancreat Surg,2008,15(3):262-269.
31. Horstmann O,Markus PM,Ghadimi MB,et al.Pylorus preservation has no impact on delayed gastric emptying after pancreatic head resection[J].Pancreas,2004,28(1):69-74.
32. 高红桥,杨尹默,庄岩,等.保留幽门胰十二指肠切除术后发生胃排空延迟的影响因素分析[J].中华外科杂志,2007,45(15):1048-1051.
33. Khan AS,Hawkins WG,Linehan DC.A technique of gastrojejunostomy to reduce delayed gastric emptying after pancreatoduodenectomy[J].J Gastrointest Surg,2011,15(8):1468-1471.
34. Su AP,Cao SS,Zhang Y,et al.Does antecolic reconstruction for duodenojejunostomy improve delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy? A systematic review and meta-analysis[J].World J Gastroenterol,2012,18(43):6315-6323.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparison on Effectiveness of Antecolic Duodenojejunostomy and Retrocolic Duodenojejunostomy after Pylorus-Preserving Pancreaticoduodenectomy: A Meta-Analysis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content