The Effect of Braun’s Enteroenterostomy on Delayed Gastric Emptying in Binding Pancreaticogastrostomy Following Pancreaticoduodenectomy: a Comparative Study and Review of Literature

Delayed gastric emptying (DGE) is the most common complications after Whipple pancreaticoduodenectomy (WPD). Braun enteroenterostomy (BEE) is a useful technique to divert bile from the stomach. We recently started doing binding pancreaticogastrostomy (BPG) for pancreatic reconstruction after WPD, and the most frequent complication was DGE. The aim was to study the effect of Braun enteroenterostomy on delayed gastric emptying in binding pancreaticogastrostomy following Whipple pancreaticoduodenectomy. The study included all patients who underwent BEE in BPG following WPD from February 2014 till May 2016 at a tertiary care center. Braun enteroenterostomy was constructed approximately 25 cm distal to the gastrojejunostomy by a side-to-side hand-sewn or stapled anastomosis. Delayed gastric emptying was defined as per International Study Group of Pancreatic Surgery (ISGPS) definition. All patient data including patient demographics, type of procedure performed, complications, mortality, hospital stay, postoperative interventions, or re-operations were documented. There were 13 (30.95%) patients with DGE A and 4 (9.52%) patients with DGE B, and no patients had DGE C. Hence, there were only 4 patients (9.52%) with clinically significant DGE. Addition of Braun enteroenterostomy reduces delayed gastric emptying after Whipple pancreaticoduodenectomy with binding pancreaticogastrostomy.