Document Detail

Reflux esophagitis and marginal ulcer after pancreaticoduodenectomy.
MedLine Citation:
PMID:  21347872     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Reflux esophagitis is a common complication following a distal gastrectomy. Increasingly, Roux-en-Y reconstruction has been used to prevent reflux esophagitis; however, marginal ulcer is a concern in patients with a Roux-en-Y reconstruction after distal gastrectomy. The effect of Roux-en-Y reconstruction on the development of reflux esophagitis and marginal ulcer after pancreaticoduodenectomy (PD) has not been studied.
METHODS: We retrospectively studied both reflux esophagitis and marginal ulcer after 371 PDs and analyzed the association with different methods of gastrointestinal reconstruction.
RESULTS: In a median follow-up time of 20 months, 40 (10.8%) of the 371 patients developed reflux esophagitis, 15 after 158 standard PD, and 25 after 213 pylorus-preserving pancreaticoduodenectomy (PPPD; P = 0.62). Cox regression model showed Roux-en-Y reconstruction was significantly inversely related to occurrence of reflux esophagitis in 158 patients after standard PD (P = 0.04) but not in 213 patients after PPPD (P = 0.24). Thirty-five of 371 studied patients developed marginal ulcer, 15 after standard PD and 20 after PPPD (P = 0.45). Multivariate analysis showed that Roux-en-Y reconstruction was the only significant predictor for marginal ulcer after PD (P = 0.02).
CONCLUSIONS: Our data support the use of Roux-en-Y reconstruction after standard PD but not after PPPD.
Jin-Ming Wu; Meng-Kun Tsai; Rey-Heng Hu; Kin-Jen Chang; Po-Huang Lee; Yu-Wen Tien
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2011-02-24
Journal Detail:
Title:  Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract     Volume:  15     ISSN:  1873-4626     ISO Abbreviation:  J. Gastrointest. Surg.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-22     Completed Date:  2011-09-22     Revised Date:  2012-02-29    
Medline Journal Info:
Nlm Unique ID:  9706084     Medline TA:  J Gastrointest Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  824-8     Citation Subset:  IM    
Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, 7 Chung-Shan South Rd, 10002, Taipei, Taiwan, Republic of China.
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MeSH Terms
Bile Duct Diseases / surgery*
Endoscopy, Gastrointestinal
Esophagitis, Peptic / diagnosis,  epidemiology,  etiology*
Follow-Up Studies
Middle Aged
Pancreaticoduodenectomy / adverse effects
Postoperative Complications
Retrospective Studies
Stomach Ulcer / diagnosis,  epidemiology,  etiology*
Taiwan / epidemiology
Comment In:
J Gastrointest Surg. 2012 Feb;16(2):452   [PMID:  22089953 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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