Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.

We have previously reported our efforts to minimize postgastrectomy symptoms in two patients with benign disease who underwent resection of the head of the pancreas and the duodenum. In these cases the pylorus and first portion of the duodenum were preserved during pancreaticoduodenectomy. Our exper...

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Main Authors: Traverso, L W, Longmire, W P
Formato: Artigo
Idioma:English
Publicado em: 1980
Assuntos:
Research Article
Acesso em linha:https://ncbi.nlm.nih.gov/pmc/articles/PMC1344905/
https://ncbi.nlm.nih.gov/pubmed/7416828
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spelling pubmed-13449052006-04-11 Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation. Traverso, L W Longmire, W P Ann Surg Research Article We have previously reported our efforts to minimize postgastrectomy symptoms in two patients with benign disease who underwent resection of the head of the pancreas and the duodenum. In these cases the pylorus and first portion of the duodenum were preserved during pancreaticoduodenectomy. Our experience has now been extended to encompass 18 patients, eight of whom were available for comprehensive evaluation an average of six months postoperation. These studies have attempted to differentiate malabsorption of pancreatic insufficiency from possible gastrointestinal dysfunction of the new alimentary connection. Pancreatic insufficiency was evaluated by a 72-hour stool collection and radioactive trioctanoate (RATO) test. Gastrointestinal absorption was evaluated by D-xylose excretion and the Schilling test, as well as serum vitamin. A, vitamin B-12, carotene, folate, iron, and total iron binding capacity. Gastrointestinal secretion and motility were assessed by using pyloric fluoroscopy, gastric barium emptying, the Hunt test, and gastric acid analysis. Finally, a questionnaire regarding clinical symptoms of postgastrectomy syndromes and malabsorption was answered. Although every patient exhibited marked pancreatic insufficiency by laboratory tests, 88% described normal formed bowel movements, and weight loss was claimed by only 25%. Other test findings were generally normal. While the follow-up period has been limited to three years, the current data demonstrate that gastrointestinal function subsequent to preservation of the pylorus has not thus far predisposed to postgastrectomy syndromes or marginal ulcers. All of the patients required intensive pancreatic enzyme replacement. 1980-09 /pmc/articles/PMC1344905/ /pubmed/7416828 Text en
institution US National Library of Medicine
collection PubMed Central
language English
format Article
topic Research Article
spellingShingle Research Article
Traverso, L W
Longmire, W P
Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
description We have previously reported our efforts to minimize postgastrectomy symptoms in two patients with benign disease who underwent resection of the head of the pancreas and the duodenum. In these cases the pylorus and first portion of the duodenum were preserved during pancreaticoduodenectomy. Our experience has now been extended to encompass 18 patients, eight of whom were available for comprehensive evaluation an average of six months postoperation. These studies have attempted to differentiate malabsorption of pancreatic insufficiency from possible gastrointestinal dysfunction of the new alimentary connection. Pancreatic insufficiency was evaluated by a 72-hour stool collection and radioactive trioctanoate (RATO) test. Gastrointestinal absorption was evaluated by D-xylose excretion and the Schilling test, as well as serum vitamin. A, vitamin B-12, carotene, folate, iron, and total iron binding capacity. Gastrointestinal secretion and motility were assessed by using pyloric fluoroscopy, gastric barium emptying, the Hunt test, and gastric acid analysis. Finally, a questionnaire regarding clinical symptoms of postgastrectomy syndromes and malabsorption was answered. Although every patient exhibited marked pancreatic insufficiency by laboratory tests, 88% described normal formed bowel movements, and weight loss was claimed by only 25%. Other test findings were generally normal. While the follow-up period has been limited to three years, the current data demonstrate that gastrointestinal function subsequent to preservation of the pylorus has not thus far predisposed to postgastrectomy syndromes or marginal ulcers. All of the patients required intensive pancreatic enzyme replacement.
author Traverso, L W
Longmire, W P
author_facet Traverso, L W
Longmire, W P
author_sort Traverso, L W
title Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
title_short Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
title_full Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
title_fullStr Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
title_full_unstemmed Preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
title_sort preservation of the pylorus in pancreaticoduodenectomy a follow-up evaluation.
publishDate 1980
url https://ncbi.nlm.nih.gov/pmc/articles/PMC1344905/
https://ncbi.nlm.nih.gov/pubmed/7416828
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