Апаратне формування дуоденоентеро- та гастроентероанастомозів при панкреатодуоденектомії: оптимізація реконструктивного етапу

Ігор Хом’як; Олександр Литвин; Сергій Мотельчук; Андрій Малик

doi:10.64124/DMR-2026-1-ORSR-3

Authors

Igor Khomiak National Scientific Center of surgery and transplantation named after O. O. Shalimov to National Academy of medical sciences of Ukraine Author https://orcid.org/0000-0002-3299-7840
Alexandr Lytvyn National Scientific Center of surgery and transplantation named after O. O. Shalimov to National Academy of medical sciences of Ukraine Author https://orcid.org/0000-0003-4819-4070
Serhii Motelchuk National Scientific Center of surgery and transplantation named after O. O. Shalimov to National Academy of medical sciences of Ukraine Author https://orcid.org/0000-0002-9391-8149
Andrii Malyk National Scientific Center of surgery and transplantation named after O. O. Shalimov to National Academy of medical sciences of Ukraine Author https://orcid.org/0000-0001-9628-0999

DOI:

https://doi.org/10.64124/DMR-2026-1-ORSR-3

Keywords:

delayed gastric emptying, pancreatoduodenectomy, duodenojejunostomy, gastrojejunostomy, stapled anastomosis

Abstract

Background. Delayed gastric emptying (DGE) following pancreatoduodenectomy (PD) remains one of the most common and clinically significant complications, substantially affecting the course of the early postoperative period. Its development is associated with prolonged hospitalization, the need for extended nasogastric decompression, delayed initiation of enteral nutrition, and an increased risk of infectious complications. Furthermore, DGE negatively impacts patients’ nutritional status, slows functional recovery, and reduces quality of life in the postoperative period.
Objective. To evaluate the efficacy of stapled gastro- and duodenojejunostomy during pancreatoduodenectomy in preventing the occurrence of delayed gastric emptying.
Materials and Methods. A total of 136 PD cases (2019–2024) were analyzed: 102 involved manual suturing and 34 mechanical (stapled) anastomosis.
Results. DGE occurred in 25.5% of patients in the manual suture group and 14.7% in the stapled anastomosis group (p < 0.242). The duration of nasogastric tube use was reduced in the early postoperative period (2 vs. 7 days), as were the timelines for initiating nutrition (3 vs. 7 days).
Conclusions. The use of stapling devices for the formation of duodenojejunal and gastrojejunal anastomoses during pancreatoduodenectomy is associated with a trend toward decreased delayed gastric emptying. This is attributed to more standardized anastomosis formation, reduced tissue trauma, and superior suture integrity, which helps preserve the motor-evacuatory function of the stomach in the postoperative period.

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