Pylorus preserving pancreaticoduodenectomy with low incidence of early delayed gastric emptying.

BACKGROUND AND OBJECTIVE: Early delayed gastric emptying (early DGE) is a common complication after pylorus-preserving pancreaticoduodenectomy (PPPD). The authors studied the occurrence of early DGE in the presented patients. The explanation of authors' results was discussed and a brief literature review was performed. MATERIAL AND METHOD: The occurrence of early DGE was studied in 37 patients with periampullary neoplasms or other benign conditions who underwent PPPD between from April 1992 and March 2006. The operations were performed by the first author with uniform surgical techniques. After the year 2000, an external pancreatic stent was routinely inserted into the pancreatic duct during pancreaticojejunostomy anastomosis. RESULTS: Early DGE occurred in two patients (5.4%), one in the non-stented and one in the stented group. Two patients had pancreatic fistula and two had wound infection. The overall morbidity rate was 16.2%. There was no re-operation or intra-abdominal abscess requiring drainage or mortality in the present study. CONCLUSIONS: The occurrence of early DGE after PPPD may be lessened by strict awareness and avoidance of complications associated with PPPD. Surgical experiences with faultless and meticulous surgical techniques are important for lowering such complications.