Effects of adding Braun jejuno-jejunostomyto standard Whipple Procedure on reduction of Morbidity.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2018, Vol 3, Issue 11
Abstract
Background: Whipple operation remains the gold standard treatment modality for periampullary tumour, distal CBD tumour, head of pancreas tumour and duodenal tumours. Though mortality has been brought down significantly ,the morbidity poses a big challenge in the post-operative period in the form of delayed gastric emptying ,severe bile reflux and QOL(recurrent vomiting ,repeated hospital admissions, post cibal discomfort). Braun jejuno-jejunostomy (side-to-side anastomosis of afferent and efferent limbs of thegastrojejunal anastomotic loop) could be performed rapidly which is supposed to help in reducing the morbidity significantly in Whipple surgery Methods: The aim of the study was to compare the effectiveness of addition ofBraun anastomosis to the Whipple operation with the standard Whipple operation without Braun anastomosis ..This is a retrospective observational study from June 2015 to June 2018.: There were 24 patients who underwent standard Whipple operation without Braun anastomosis and12 patients underwent Braun anastomosis to the standard Whipple operation who were observed and taken up for study to assess the effectiveness in terms of reducing post-operative morbidity ,especially the Delayed gastric emptying, recurrent vomiting and repeated hospital admissions and postoperative QOL Results: Out of 36patients 14 patients (38.8%) are females and 22 (61.2%) patients are males. Though all patients had similar demographic presentations, those who had Braun anastomosis in addition to standard Whipple operation experienced 0% delayed gastric emptying compared to 20% in standard procedure ,had no leak versus 8.2% leak rate in standard Whipple operation , got delayed discharge only in 8.3% compared to 20.8 %in standard Whipples operation Conclusions: Addition of Braun Jejuno-Jejunostomy to standard Whipple procedure reduces the incidence of delayed gastric emptying,postoperative alkaline bile reflux, early discharge from the hospital and avoid repeated hospital admissions and improve the Quality of life. But it needs further validation with more volume of cases and randomized trials.
Authors and Affiliations
Dr. Selvaraj. T.
Keywords
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