Very Simple and Reliable Procedure, ‘Vertical Gastric Positioning’, To Prevent Delayed Gastric Emptying after Pancreatoduodenectomy

Takashi Orii*, Masaki Yoshimura, Hiroe Kitahara and Yukihiko Karasawa

Department of Gastrointestinal Surgery, Showa Inan General Hospital, Japan

^*Correspondance to: Takashi Orii 

 PDF  Full Text DOI: 10.25107/2474-1647.2768

Abstract

Purpose: Delayed gastric emptying is a major complication after pancreatoduodenectomy, and causes malnutrition owing to delayed oral feeding, leading to long hospital stays and increased hospitalization costs. It occurs at an incidence of 9%~30%. We have used vertical gastric positioning for several years for the treatment of delayed gastric emptying; therefore, we recommended its implementation. Herein we describe the procedure and report its efficacy. Methods: Thirty-nine of 70 patients who underwent pancreatoduodenectomy in our hospital underwent pylorus-preserving pancreatoduodenectomy. A duodenojejunostomy was set at 40 cm distal from the hepaticojejunostomy, and the long axis of the stomach was placed vertical to the ground along the left abdominal wall without fixation to the surrounding tissue. Results: Delayed gastric emptying of grade B occurred in only one (2.6%) of 39 cases. Eight patients discontinued oral food intake, but the causes were not related to delay gastric emptying. One patient did not begin oral feeding until 27 days after pancreatoduodenectomy owing to a grade B pancreatic fistula. Conclusion: The incidence of delayed gastric emptying associated with vertical gastric positioning was as low as 2.6%. If the efficacy of this procedure can be established, it should easily become prevalent in view of its technical simplicity.

Keywords

Vertical gastric positioning; Delayed gastric emptying; Pylorus preserving pancreatoduodenectomy

Cite the article

Orii T, Yoshimura M, Kitahara H, Karasawa Y. Very Simple and Reliable Procedure, ‘Vertical Gastric Positioning’, To Prevent Delayed Gastric Emptying after Pancreatoduodenectomy. Clin Surg. 2020; 5: 2768.