ESTIMATION OF RECONSTRUCTION TYPES FOLLOWING PANCREATODUODENECTOMY WITH GASTROINTESTINAL MOTILITY
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It is reported that patients with pylorus-preserving pancreatoduodenectomy (PpPD) could get better nutritional conditions than standard pancreatoduodenectomy (PD), after recovery from gastric stagnation following PpPD. In order to estimate postoperative functions of each procedure, we investigated serial changes of gastrointestinal motility and nutritional parameters of patients after PD (n=10) vs. PpPD easurement of gastic emptying and intestinal transit. Delayed gastric emptying and accelerated intestinal transit one month after PpPD were normalized at 6 months or later, while accelerated gastric emptying and intestinal transit of PD patients continued for a long period. Body weights and serum cholesterol levels of PpPD patients were recovered better than those of PD at 6 months or later. Although there were no differences in gastrointestinal motility and nutritional parameters between Billroth I type (gastro-pancreato-biliary) and Billroth II type (pancreato-biliary-gastric) reconstruction following PpPD, postoperative gastric stagnation occured more often in Billroth I type. Thus, we take advantage in PpPD over PD and in Billroth II type over Billroth I type reconstruction following PpPD.
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