학술논문
Effectiveness of Zero-Angle Gastrojejunostomy Anastomosis Technique Applied to Pancreaticoduodenectomy on Delayed Gastric Emptying/Pankreatikoduodenektomide Sifir Aci ile Yapilan Gastrojejunostomi Anastomoz Tekniginin Mide Bosalim Uzerine Etkinligi
ORIGINAL INVESTIGATION/OZGUN ARASTIRMA
ORIGINAL INVESTIGATION/OZGUN ARASTIRMA
Document Type
Report
Author
Source
Istanbul Kanuni Sultan Suleyman Medical Journal (Istanbul Kanuni Sultan Suleyman Tıp Dergisi). January 2022, Vol. 14 Issue 1, p27, 8 p.
Subject
Language
English
ISSN
2148-273X
Abstract
INTRODUCTION Although the development of surgical techniques for the pancreas, intensive care facilities, determination of patient selection criteria, and multidisciplinary approaches have reduced mortality rates to 1-3% after pancreaticoduodenectomy (PD) [...]
Objective: This study aims to investigate the effectiveness of the gastrojejunostomy anastomosis method performed at zero angle in pancreaticoduodenectomy in reducing delayed gastric emptying (DGE). Method: Patients who underwent a pancreaticoduodenectomy between January 2014 and July 2017 (n=57) (Group 1) and those who underwent between August 2017 and January 2020 (n=90) (Group 2) were included in this study in two groups. There were patients who consecutively underwent anastomosis with irregular angles before August 2017. Then, gastrojejunostomy was applied at zero angle. The patients were evaluated in terms of age, gender, duration of surgery, preoperative blood loss, wound site infection, postoperative bleeding, gastric emptying difficulty, American Society of Anesthesiology (ASA) score, body mass index (BMI), pancreatic fistula, and the length of hospital stay. Results: A total of 147 patients were included in the study. It was shown that 14.3% of the patients had DGE. DGE was observed at a rate of 24.6% with 14 patients in Group 1 and a rate of 7.8% with 7 patients in Group 2 (p=0.019). There was no statistically significant difference in the other features of the patients. Conclusion: Gastrojejunostomy performed with zero angle and one-third of resection causes significantly less DGE when compared with irregular methods. Keywords: Blumgart anastomosis, delayed gastric emptying, pancreatic fistula, pancreaticoduodenectomy Amac: Bu calismada pankreatikoduodenektomide sifir aci teknigi ile yapilan gastrojejunostomi anatomoz tekniginin mide bosalim guclugunu azaltmadaki etkinligini arastirmayi hedefledik. Yontem: Bu calismaya Ocak 2014-Temmuz 2017 tarihleri arasinda pankreatikoduodenektomi uyguladigimiz hastalar n: 57 (Grup 1) ile Agustos 2017-Ocak 2020 tarihleri arasinda pankreatikodudenektomi uyguladigimiz hastalar n: 90 (Grup 2) calismaya iki grup olarak dahil edildi. Agustos 2017 oncesi duzensiz aci ile anastomoz yapilan hastalar ardisik olarak mevcuttu, sonrasinda klinik karari ile sifir derece aciyla gastrojejunostomi uygulanmaya baslandi. Hastalar yas, cinsiyet, ameliyat suresi, preoperatif kan kaybi, yara yeri enfeksiyonu, postoperatif kanama, mide bosalim guclugu, ASA skoru, vucut kitle indeksi (VKI), pankreatik fistul, hastanede yatis suresi acisindan degerlendirildi. Bulgular: Toplam 147 hasta calismaya dahil edildi. Tum hastalar incelendiginde %16,6 oraninda mide bosalim guclugu izlendi. Iki grup karsilastirildiginda. Grup 1 'de 14 hastada %24,5 grup ikide ise 7 hastada %7,77 oraninda mide bosalim guclugu izlendi (p=0,034). Hastalar yas, cinsiyet, ameuyat suresi, preoperatif kan kaybi, yara yeri enfeksiyonu, postoperatif kanama acisindan degerlendirildiginde iki grup arasinda anlamli fark olmamakla beraber pankreatik fistul. hastanede yatis suresi acisindan iki grup arasinda anlamli fark vardi. Sonuc: Sifir derece aci ve 1/3 oraninda rezeksiyon ile yapilan gastrojejunostomi duzensiz teknikler ile karsilastirildiginda anlamli olarak daha az mide bosalim guclugune sebep olmaktadir. Anahtar kelimeler: Blumgart anastomoz, mide bosalim guclugu, pankreatik fistul, pankretikoduodenektomi
Objective: This study aims to investigate the effectiveness of the gastrojejunostomy anastomosis method performed at zero angle in pancreaticoduodenectomy in reducing delayed gastric emptying (DGE). Method: Patients who underwent a pancreaticoduodenectomy between January 2014 and July 2017 (n=57) (Group 1) and those who underwent between August 2017 and January 2020 (n=90) (Group 2) were included in this study in two groups. There were patients who consecutively underwent anastomosis with irregular angles before August 2017. Then, gastrojejunostomy was applied at zero angle. The patients were evaluated in terms of age, gender, duration of surgery, preoperative blood loss, wound site infection, postoperative bleeding, gastric emptying difficulty, American Society of Anesthesiology (ASA) score, body mass index (BMI), pancreatic fistula, and the length of hospital stay. Results: A total of 147 patients were included in the study. It was shown that 14.3% of the patients had DGE. DGE was observed at a rate of 24.6% with 14 patients in Group 1 and a rate of 7.8% with 7 patients in Group 2 (p=0.019). There was no statistically significant difference in the other features of the patients. Conclusion: Gastrojejunostomy performed with zero angle and one-third of resection causes significantly less DGE when compared with irregular methods. Keywords: Blumgart anastomosis, delayed gastric emptying, pancreatic fistula, pancreaticoduodenectomy Amac: Bu calismada pankreatikoduodenektomide sifir aci teknigi ile yapilan gastrojejunostomi anatomoz tekniginin mide bosalim guclugunu azaltmadaki etkinligini arastirmayi hedefledik. Yontem: Bu calismaya Ocak 2014-Temmuz 2017 tarihleri arasinda pankreatikoduodenektomi uyguladigimiz hastalar n: 57 (Grup 1) ile Agustos 2017-Ocak 2020 tarihleri arasinda pankreatikodudenektomi uyguladigimiz hastalar n: 90 (Grup 2) calismaya iki grup olarak dahil edildi. Agustos 2017 oncesi duzensiz aci ile anastomoz yapilan hastalar ardisik olarak mevcuttu, sonrasinda klinik karari ile sifir derece aciyla gastrojejunostomi uygulanmaya baslandi. Hastalar yas, cinsiyet, ameliyat suresi, preoperatif kan kaybi, yara yeri enfeksiyonu, postoperatif kanama, mide bosalim guclugu, ASA skoru, vucut kitle indeksi (VKI), pankreatik fistul, hastanede yatis suresi acisindan degerlendirildi. Bulgular: Toplam 147 hasta calismaya dahil edildi. Tum hastalar incelendiginde %16,6 oraninda mide bosalim guclugu izlendi. Iki grup karsilastirildiginda. Grup 1 'de 14 hastada %24,5 grup ikide ise 7 hastada %7,77 oraninda mide bosalim guclugu izlendi (p=0,034). Hastalar yas, cinsiyet, ameuyat suresi, preoperatif kan kaybi, yara yeri enfeksiyonu, postoperatif kanama acisindan degerlendirildiginde iki grup arasinda anlamli fark olmamakla beraber pankreatik fistul. hastanede yatis suresi acisindan iki grup arasinda anlamli fark vardi. Sonuc: Sifir derece aci ve 1/3 oraninda rezeksiyon ile yapilan gastrojejunostomi duzensiz teknikler ile karsilastirildiginda anlamli olarak daha az mide bosalim guclugune sebep olmaktadir. Anahtar kelimeler: Blumgart anastomoz, mide bosalim guclugu, pankreatik fistul, pankretikoduodenektomi