caa a22 4500 606246908 CHVBK 20210128101342.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-013-0992-3 doi (NATIONALLICENCE)springer-10.1007/s12262-013-0992-3 Preventing Delayed Gastric Emptying After Whipple's Procedure—Isolated Roux Loop Reconstruction With Pancreaticogastrostomy [Elektronische Daten] [Asuri Krishna, Virinder Bansal, Subodh Kumar, P. Sridhar, Sameer Kapoor, Mahesh Misra, Pramod Garg] Although delayed gastric emptying (DGE) after Whipple's pancreaticoduodenectomy is not life-threatening and can be treated conservatively, it results in discomfort and significant prolongation of the hospital stay and adds on to the hospital costs. To overcome this problem, we started using the isolated loop technique of reconstruction along with pancreaticogastrostomy and we present our series using this technique. All consecutive patients undergoing Whipple's pancreaticoduodenectomy in a single surgical unit from January 2009 until December 2012 were included. In the absence of hepatic and peritoneal metastasis, resection (Whipple's procedure) with curative intent was done using isolated loop technique with pancreaticogastrostomy. Delayed gastric emptying was assessed clinically and on oral gastrograffin study. Bile reflux was also assessed on clinical parameters and evidence of beefy friable gastric mucosa on upper GI endoscopy and presence of reflux on hepatobiliary scintigraphy. A total of 52 patients were operated using this technique from January 2009 to October 2012. The mean operative time was 260.8 ± 50.3, and the mean operative blood loss was 1,068.0 ± 606.1ml. Mean gastric emptying time 106.0 ± 6.1min (89-258min). Three out of the 52(5.7%) patients had persistent vomiting in the post-operative period requiring reinsertion of NG tube. A HIDA scan done on POD7 for all patients did not show any evidence of bile reflux in any of the patients. Pancreatogastrostomy with isolated loop in pancreaticoduodenal resection markedly reduces the post-operative incidence of alkaline reflux gastritis and DGE. Association of Surgeons of India, 2013 Whipple's procedure nationallicence Delayed gastric emptying nationallicence Isolated loop nationallicence Bile reflux nationallicence Krishna Asuri Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Bansal Virinder Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Kumar Subodh Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Sridhar P. Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Kapoor Sameer Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Misra Mahesh Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Garg Pramod Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut Indian Journal of Surgery Springer India 77(2015-12-01), 703-707 0972-2068 77<703 2015 77 12262 https://doi.org/10.1007/s12262-013-0992-3 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-013-0992-3 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Krishna Asuri Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Bansal Virinder Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Kumar Subodh Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Sridhar P. Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Kapoor Sameer Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Misra Mahesh Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 700 1- Garg Pramod Department of Surgical Disciplines, All India Institute of Medical Sciences, Room No. 5021, 5th Floor Teaching Block, New Delhi, India aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 703-707 0972-2068 77<703 2015 77 12262