YU-WEN TIENCHING-YAO YANGYAO-MING WUREY-HENG HUPO-HUANG LEE2020-11-192020-11-1920091091-255Xhttps://www.scopus.com/inward/record.uri?eid=2-s2.0-64749109016&doi=10.1007%2fs11605-009-0831-9&partnerID=40&md5=9649ac0c1f2e7af6f157267cfd2242eehttps://scholars.lib.ntu.edu.tw/handle/123456789/521342Background: Since gastroparesis is unavoidable in a certain proportion of patients after pancreaticoduodenectomy, measures to avoid its occurrence or at least minimize its impact are needed. A prospective randomized trial was performed to test the effectiveness of biliopancreatic diversion with modified Roux-en-Y gastrojejunostomy reconstruction and of enteral feeding to minimize impacts of gastroparesis after pancreaticoduodenectomy. Methods: In total, 247 patients with periampullary tumors were randomized at the time of pancreaticoduodenectomy to have either (1) modified Roux-en-Y gastrojejunostomy reconstruction (by creating a side-to-side jejunojejunostomy between afferent and efferent loop and closing the afferent loop with a TA-30-3.5 stapler) and insertion of a jejunostomy feeding tube (modified group) or (2) conventional gastric bypass (control group). Outcomes including complications, duration of nasogastric tube placement, and length of hospital stay were followed prospectively. Results: Gastroparesis occurred in 20 patients (16.3%) in the modified group and 27 patients in the control group (21.7%, P?=?0.27). However, the International Study Group of Pancreatic Surgery grades of gastroparesis were significantly lower in the modified group (10A, 5B, 5C) than in the control group (4A, 5B, 18C, P?=?0.01). Conclusions: Modified procedure does not reduce the risk of gastroparesis but appears to reduce the severity when it occurs. ? 2009 The Society for Surgery of the Alimentary Tract.[SDGs]SDG3adult; aged; article; biliopancreatic bypass; clinical trial; cohort analysis; controlled clinical trial; controlled study; duodenostomy; enteric feeding; female; human; jejunostomy; length of stay; male; methodology; middle aged; pancreas disease; pancreaticoduodenectomy; pathology; randomized controlled trial; stomach bypass; stomach paresis; treatment outcome; Adult; Aged; Biliopancreatic Diversion; Cohort Studies; Duodenostomy; Enteral Nutrition; Female; Gastric Bypass; Gastroparesis; Humans; Jejunostomy; Length of Stay; Male; Middle Aged; Pancreatic Diseases; Pancreaticoduodenectomy; Treatment Outcomejournal article10.1007/s11605-009-0831-9192242922-s2.0-64749109016