Delayed gastric emptying is associated with pylorus-preserving but not classical Whipple pancreaticoduodenectomy: A review of the literature and critical reappraisal of the implicated pathomechanism

Table 1 Association between DGE and PD/PPPD

Study	Yr	Patients (n)	Results
Klinkenbijl et al[20]	1992	91 (44 PDs, 47 PPPDs)	No difference with regards to DGE was demonstrated between the two groups (i.e. days to liquid and normal diet)
Roder et al[12]	1992	110 (62 PDs, 48 PPPDs)	DGE was noted in 0 (0%) patients after PD and 9 (19%) patients after PPPD (P value not mentioned)
Patel et al[25]	1995	67 (52 PDs, 15 PPPDs)	DGE was noted in 41% of the PD group and 61% of the PPPD group (P = 0.04)
Mosca et al[90]	1997	218 (61 PDs, 157 PPPDs	DGE was noted in 1 (4.7%) patient after PD and 14 (8.9%) patients after PPPD (P value not mentioned).
van Berge Henegouwen et al[34]	1997	200 (100 PDs, 100 PPPDs)	DGE was noted in 34 patients after PD and 37 patients after PPPD (P = NS)1
Lin and Lin[63]	1999	30 (15 PDs, 15 PPPDs)	DGE was noted in 1 patient after PD and 6 patients after PPPD (P = 0.08, two-sided Fisher’s exact test, NS)
Di Carlo et al[91]	1999	113 (39 PDs, 74 PPPDs)	DGE was noted in 6 (15.3%) patients after PD and 9 (12.1%) patients after PPPD (P = NS)
Yeo et al[92]	1999	106 (58 PDs, 48 PPPDs)2	DGE was noted in 9 (16%) patients after PD and 2 (4%) patients after PPPD (P = 0.03)
Seiler et al[93]	2000	77 (40 PDs, 37 PPPDs)	DGE was noted in 18 (45%) patients after PD and 12 (32%) patients after PPPD (P = 0.17, NS)
Martignoni et al[66]	2000	62 (27 PDs, 35 PPPDs)	DGE was noted in 9 (33%) patients after PD and 13 (37%) patients after PPPD (P = NS)
Yamaguchi et al[94]	2001	50 (27 PDs, 23 PPPDs)	DGE was significantly associated with PPPD compared with PD (gastric tube removal, P < 0.0001, oral intake, P = 0.0018)
Yeo et al[6]	2002	294 (148 PDs, 146 PPPDs)	DGE was noted in 24 (16%) patients after PD and 9 (6%) patients after PPPD (P = 0.006)
Nguyen et al[95]	2003	105 (50 PDs, 55 PPPDs)	DGE was noted in 6 of 50 (12%) patients after PD and 4 of 55 (7%) patients after PPPD (P = 0.40, NS)
Horstmann et al[73]	2004	132 (19 PDs, 113 PPPDs)4	DGE was noted in 4 of 19 (21%) patients after PD and 13 of 113 (12%) patients after PPPD (P = 0.11, NS)
Tran et al[77]	2004	170 (83 PDs, 87 PPPDs)5	DGE was noted in 18 patients after PD and 19 patients after PPPD (P = 0.80, NS)
Seiler et al[96]	2005	130 (66 PDs, 64 PPPDs)	DGE was noted in 30 (45%) patients after PD and 20 (31%) patients after PPPD (P = 0.096, NS)
Lin et al[97]	2005	33 (19 PDs, 14 PPPDs)6	DGE was noted in 6 (43%) patients after PD and 0 patients after PPPD (P < 0.05)

NS: Not significant.

¹Although nasogastric intubation was prolonged after PPPD vs PD (3 vs 6 d, P < 0.0001), this did not influence DGE rates;

²Initially 114 patients were included in the study. Of these, 58 underwent PD while the remaining 56 were scheduled for PPPD. However, in 8 patients, the pylorus could not be preserved. They were therefore not included in the results; ³In 7 of 55 (13%) patients in the PPPD group, the pylorus could not be preserved;

⁴A total of 150 patients were included in the study but the 18 patients that underwent duodenum-preserving pancreatic head resection were not included here;

⁵Two patients in the PPPD group were converted to the PD group during operation as the surgeon expected duodenal involvement;

⁶Initially 36 patients were included in the study. Three patients with pancreatic head adencarcinoma initially assigned to the PPPD group, had to undergo PD eventually due to extensive duodenal involvement. These 3 patients were not calculated in either study groups.