Pancreatic Cancer Clinical Trial
Official title:
Influence of the Reconstruction Method on the Incidence of Delayed Gastric Emptying After Pylorus Preserving Pancreaticoduodenectomy. A Prospective, Randomized Trial.
Pancreaticoduodenectomy (whipple procedure) is the standard operation for tumors of the
pancreatic head, uncinate process, distal common bile duct as well as the papilla of vater.
For reconstruction, pylorus-preservation (PPPD) has been shown to be technically and
oncologically equivalent to the traditional whipple operation. One issue with this technique
is delayed gastric emptying (DGE), which occurs in 25-70% of patients, usually emerging
between day 4 and 14 after surgery. Patients with severe DGE can not only experience
prolonged length of hospital stay, but are also at increased risk for other complications
like aspiration or other issues related to the inability to ingest nutrition.
There is vast retrospective evidence and one prospective study indicating that antecolic
reconstruction of the duodenojejunostomy can improve the rate and severity of delayed
gastric emptying.
The investigators have conducted a prospective randomized trial in order to test this
hypothesis. Patients were randomized to either undergo antecolic or retrocolic
reconstruction after PPPD. On day 10 after surgery, DGE was assessed by clinical criteria.
In addition, a test meal including 1g paracetamol was administered to check for clinically
inapparent DGE. Of these serum samples, kinetics of intestinal peptides like GLP-1, PYY and
glucagon was alos measured.
n/a
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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