Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)

Purpose: pylorus-preserving pancreatoduodenectomy (PPPD) has been the gold standard for pancreatic head lesion resection for several years. Some studies have noted that it involves more delayed gastric emptying (DGE) than classical Whipple (i.e., pancreatoduodenectomy with antrectomy). Our working h...

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Autores: Busquets, J., Martín, S., Secanella, Ll., Sorribas, M., Cornellà, Natalia, Altet Torné, Juan, Peláez, N., Bajen, M., Carnaval, T., Videla, Sebastià, Fabregat, J.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2022
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/54962
Acceso en línea:http://hdl.handle.net/10230/54962
http://dx.doi.org/10.1007/s00423-022-02583-9
Access Level:acceso abierto
Palabra clave:Classical Whipple
Delayed gastric emptying
Pyloric preservation
Pylorus-preserving pancreatoduodenectomy
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spelling Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)Busquets, J.Martín, S.Secanella, Ll.Sorribas, M.Cornellà, NataliaAltet Torné, JuanPeláez, N.Bajen, M.Carnaval, T.Videla, SebastiàFabregat, J.Classical WhippleDelayed gastric emptyingPyloric preservationPylorus-preserving pancreatoduodenectomyPurpose: pylorus-preserving pancreatoduodenectomy (PPPD) has been the gold standard for pancreatic head lesion resection for several years. Some studies have noted that it involves more delayed gastric emptying (DGE) than classical Whipple (i.e., pancreatoduodenectomy with antrectomy). Our working hypothesis was that the classical Whipple has a lower incidence of DGE. We aimed to compare the incidence of DGE among pancreatoduodenectomy techniques. Methods: This pragmatic, randomized, open-label, single-center clinical trial involved patients who underwent classical Whipple (study group) or PPPD (control group). Gastric emptying was clinically evaluated using scintigraphy. DGE was defined according to the International Study Group of Pancreatic Surgery (ISGPS) criteria. The secondary endpoints were postoperative morbidity, length of hospital stay, anthropometric measurements, and nutritional status. Results: a total of 84 patients were randomized (42 per group). DGE incidence was 50% (20/40, 95% confidence interval (95% CI): 35-65%) in the study group and 62% (24/39, 95% CI: 46-75%) in the control group (p = 0.260). No differences were observed between both groups regarding postoperative morbidity or length of hospital stay. Anthropometric measurements at 6 months post-surgery: triceps fold measurements were 12 mm and 16 mm (p = 0.021). At 5 weeks post-surgery, triceps fold measurements were 13 mm and 16 mm (p = 0.020) and upper arm circumferences were 26 cm and 28 cm (p = 0.030). No significant differences were observed in nutritional status. Conclusion: DGE incidence and severity did not differ between classical Whipple and PPPD. Some anthropometric measurements may indicate a better recovery with PPPD.SpringerOpen202220222022info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/54962http://dx.doi.org/10.1007/s00423-022-02583-9reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésCopyright © Busquets J, Martín S, Secanella L, Sorribas M, Cornellà N, Altet J, et al. 2022. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.http://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessoai:recercat.cat:10230/549622026-05-29T05:05:01Z
dc.title.none.fl_str_mv Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
title Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
spellingShingle Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
Busquets, J.
Classical Whipple
Delayed gastric emptying
Pyloric preservation
Pylorus-preserving pancreatoduodenectomy
title_short Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
title_full Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
title_fullStr Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
title_full_unstemmed Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
title_sort Delayed gastric emptying after classical whipple or pylorus-preserving pancreatoduodenectomy: a randomized clinical trial (QUANUPAD)
dc.creator.none.fl_str_mv Busquets, J.
Martín, S.
Secanella, Ll.
Sorribas, M.
Cornellà, Natalia
Altet Torné, Juan
Peláez, N.
Bajen, M.
Carnaval, T.
Videla, Sebastià
Fabregat, J.
author Busquets, J.
author_facet Busquets, J.
Martín, S.
Secanella, Ll.
Sorribas, M.
Cornellà, Natalia
Altet Torné, Juan
Peláez, N.
Bajen, M.
Carnaval, T.
Videla, Sebastià
Fabregat, J.
author_role author
author2 Martín, S.
Secanella, Ll.
Sorribas, M.
Cornellà, Natalia
Altet Torné, Juan
Peláez, N.
Bajen, M.
Carnaval, T.
Videla, Sebastià
Fabregat, J.
author2_role author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Classical Whipple
Delayed gastric emptying
Pyloric preservation
Pylorus-preserving pancreatoduodenectomy
topic Classical Whipple
Delayed gastric emptying
Pyloric preservation
Pylorus-preserving pancreatoduodenectomy
description Purpose: pylorus-preserving pancreatoduodenectomy (PPPD) has been the gold standard for pancreatic head lesion resection for several years. Some studies have noted that it involves more delayed gastric emptying (DGE) than classical Whipple (i.e., pancreatoduodenectomy with antrectomy). Our working hypothesis was that the classical Whipple has a lower incidence of DGE. We aimed to compare the incidence of DGE among pancreatoduodenectomy techniques. Methods: This pragmatic, randomized, open-label, single-center clinical trial involved patients who underwent classical Whipple (study group) or PPPD (control group). Gastric emptying was clinically evaluated using scintigraphy. DGE was defined according to the International Study Group of Pancreatic Surgery (ISGPS) criteria. The secondary endpoints were postoperative morbidity, length of hospital stay, anthropometric measurements, and nutritional status. Results: a total of 84 patients were randomized (42 per group). DGE incidence was 50% (20/40, 95% confidence interval (95% CI): 35-65%) in the study group and 62% (24/39, 95% CI: 46-75%) in the control group (p = 0.260). No differences were observed between both groups regarding postoperative morbidity or length of hospital stay. Anthropometric measurements at 6 months post-surgery: triceps fold measurements were 12 mm and 16 mm (p = 0.021). At 5 weeks post-surgery, triceps fold measurements were 13 mm and 16 mm (p = 0.020) and upper arm circumferences were 26 cm and 28 cm (p = 0.030). No significant differences were observed in nutritional status. Conclusion: DGE incidence and severity did not differ between classical Whipple and PPPD. Some anthropometric measurements may indicate a better recovery with PPPD.
publishDate 2022
dc.date.none.fl_str_mv 2022
2022
2022
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/54962
http://dx.doi.org/10.1007/s00423-022-02583-9
url http://hdl.handle.net/10230/54962
http://dx.doi.org/10.1007/s00423-022-02583-9
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv http://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv SpringerOpen
publisher.none.fl_str_mv SpringerOpen
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
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