Does antecolic reconstruction for duodenojejunostomy improve delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy? A systematic review and meta-analysis

Table 2 Surgical reconstruction, definition of delayed gastric emptying and postoperative management

Ref.	Group	Reconstruction			Definition of DGE	Indication for removing NGT	SSA	Antacid	PA
Kurosaki et al[16]	AG	II	E-T-S PJ	E-T-S DJ	(1) NGT ≥ POD 10; (2) reinsertion of NGT	Aspiration < 200 mL/d	NM	NM	NM
	RG	I	E-T-S PJ or PG	E-T-E DJ
Hartel et al[18]	AG	II	E-T-S PG	E-T-S DJ	(1) NGT ≥ POD 10; (2) inability to tolerate a solid diet ≤ POD 14	Aspiration < 500 mL/d	No	H2 blocker	NM
	RG	I		E-T-E DJ
Murakami et al[17]	AG	II	E-T-S PJ	E-T-S DJ	(1) NGT ≥ POD 10; (2) inability to tolerate regular diet ≤ POD 10; (3) vomiting ≥ 3 consecutive days after POD 5; (4) radiographic passage with water-soluble contrast medium revealing a holdup of the contrast medium in the stomach	(1) After tracheal extubation; (2) Aspiration of reintubation < 200 mL/d	Yes	PPI	Yes
	RG
Tani et al[19]	AG	II	E-T-S PJ	E-T-S DJ	(1) aspiration > 500 mL/d from NGT left ≥POD 10; (2) reinsertion of NGT; (3) failure of unlimited oral intake by POD 14	Aspiration < 500 mL/d	No	H2 blocker	No
	RG
Chijiiwa et al[20]	AG	II	E-T-S PJ	E-T-S DJ	(1) NGT ≥ POD 10; (2) reinsertion of NGT; (3) inability to tolerate an appropriate amount solid food ≤ POD 14	NM	NM	H2 blocker	No
	RG

AG: Antecolic group; RG: Retrocolic group; I, II: Billroth I and Billroth II; E-T-S: End-to-side; E-T-E: End-to-end; PJ: Pancreaticojejunostomy; PG: Pancreaticogastrostomy; DJ: Duodenojejunostomy; POD: Postoperative day; DGE: Delayed gastric emptying; NGT: Nasogastric tube; NM: Not mentioned; SSA: Somatostatin analogues; PPI: Proton pump inhibitors; PA: Prokinetic agents.