Impact of Braun anastomosis on reducing delayed gastric emptying following pancreaticoduodenectomy: a prospective, randomized controlled trial

Background The present study investigates the clinical impact of Braun anastomosis on delayed gastric emptying (DGE) after pylorus‐preserving pancreaticoduodenectomy (PPPD). Methods From February 2013 to June 2014, 60 patients were recruited for this randomized controlled trial. The incidence of DGE and its risk factors were analyzed according to whether or not Braun anastomosis was used after PPPD. Results Thirty patients were respectively enrolled in No‐Braun group and Braun group. A comparative analysis between the two groups showed no differences in sex, diagnosis, operation time, hospital stay, or postoperative complications, including pancreatic fistula. Overall DGE developed in eight patients (26.7%) in the Braun group and in 14 patients (46.7%) in the No‐Braun group (P = 0.108). However, clinically relevant DGE (grades B and C) was marginally more frequent in the No‐Braun group (23.3% vs. 3.3%, P = 0.052). In a multivariable analysis, No‐Braun anastomosis was an independent risk factor for developing clinically relevant DGE (odds ratio = 16.489; 95% confidence interval: 1.287–211.195; P = 0.031). Conclusion The overall DGE occurrence was not different between the two groups. However, No‐Braun anastomosis was an independent risk factor for developing clinically relevant DGE. Highlight In this randomized controlled trial to evaluate the effectiveness of Braun anastomosis in reducing delayed gastric emptying (DGE) after pylorus‐preserving pancreaticoduodenectomy, Hwang and colleagues found no difference in overall DGE occurrence between the groups. However, the absence of Braun anastomosis was an independent risk factor developing clinically relevant DGE.