Reflux Esophagitis and Marginal Ulcer After Pancreaticoduodenectomy
Journal
Journal of Gastrointestinal Surgery
Journal Volume
15
Journal Issue
5
Pages
824-828
Date Issued
2011
Abstract
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. © 2011 The Society for Surgery of the Alimentary Tract.
SDGs
Type
journal article