Combined Antrectomy Reduces the Incidence of Delayed Gastric Emptying after Pancreatoduodenectomy.

<bold><italic>Background:</italic></bold> There are a few reports that compare the rate of postoperative complications between subtotal stomach-preserving pancreatoduodenectomy (SSPPD) and antrectomy-combined pancreatoduodenectomy (ACPD), especially with respect to delayed gastric emptying (DGE) after pancreatoduodenectomy (PD). <bold><italic>Methods:</italic></bold> From 2002 to 2013, 628 patients who underwent SSPPD (<italic>n</italic> = 78) or ACPD (<italic>n</italic> = 550) were enrolled in this study. The rate of DGE and the nutritional status were compared between patients receiving ACPD and SSPPD. <bold><italic>Results:</italic></bold> The overall morbidity rate (<italic>p</italic> = 0.830) was comparable between both groups; however, the incidence of DGE grade B or C was significantly higher in the SSPPD group than that in the ACPD group (16 vs. 7%, <italic>p</italic> = 0.007). A multivariate analysis identified SSPPD rather than ACPD (<italic>p</italic> = 0.007) and portal vein resection and reconstruction (<italic>p</italic> = 0.028) to be independent risk factors for DGE grade B or C. The changes in the body weight and nutritional parameters 3, 6, and 12 months after surgery were comparable between 2 groups. <bold><italic>Conclusions:</italic></bold> SSPPD and not ACPD was an independent risk factor for grade B or C DGE, but the postoperative nutritional status was comparable between the 2 groups based on the limited nutritional data. Combined resection of antrum will help reduce the risk of DGE after PD. [ABSTRACT FROM AUTHOR]