Abstract
Objective. To investigate the efficacy of existing methods of formation of anastomoses and to determine the factors, influencing development of slow gastric emptying.
Materials and methods. Retrospective investigation was conducted on 102 patients in Jan. 2019 – Nov. 2021 yrs period, in whom pyloro-preserving pancreaticoduodenectomy in accordance to Traverso was performed versus excision of pylorus in accordance to Whipple. The patients were distributed into two Groups: Group I - 26 patients, in whom the operation was complicated by slow gastric emptying, and Group II - 76 without such symptoms.
Results. Postoperative complications were diagnosed in 43 (42.2%) patients, and slow gastric emptying - in 26 (25.5%). External pancreatic fistula was revealed in 14 (13.7%) patients, while clinically significant fistulas of grades B and C - in 9 (8.8%). Among 26 patients with slow gastric emptying in 16 there was grade of severity A, in 8 - B, and in 2 - C. Thus, the gastrojejunostomy type applied statistically significantly (p < 0.05) influenced a slow gastric emptying occurrence. The type of pancreatojejunostomy applied did not influenced (p = 0.85) a slow gastric emptying occurrence. The patients with complications have had more stationary stay – by 6 days at average. General surgical complications, pancreatic fistulas statistically significantly (p ≤ 0.001and p < 0.05, accordingly) were connected with clinically significant slow gastric emptying; while concerning biliary fistulas, hemorrhage such a correlation was not revealed (p = 0.75 and p = 0.44, accordingly).
Conclusion. External pancreatic fistula and common surgical complications, the gut reconstruction pattern in pancreaticoduodenectomy (antecolic or retrocolic), connected with insufficient gastric evacuation, were determined as the main influencing factors in development of gastric motor function disorders. The patients with slow gastric emptying need complex conservative treatment and long period of time for their evacuation function restoration. For such patients it is necessary to guarantee a selective help and rapid ways of rehabilitation, as well as to prevent the complications occurrence. Thus, it is necessary to proceed with further investigations for surgical reconstructive procedures in pancreaticoduodenectomy.