Project Details
Projekt
The effect of Braun enteroenterostomy on the postoperative outcome after pylorus-preserving pancreaticoduodenectomy – RECOPS-Study
Applicant
Dr. Stephan Schorn
Subject Area
General and Visceral Surgery
Term
since 2020
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 416055422
The treatment of choice of malignant but also many benign tumors of the pancreatic head is a partial pancreaticoduodenectomy with the resection of the pancreatic head, the duodenum, the gall bladder, the common bile duct and as appropriate the distal part of the stomach (PD). Operations of the pancreatic head harbours mortality rates up to 2-10% and morbidity rates exceeding 50% depending on the experience of the surgical unit. Here, postoperative pancreatic fistulas (POPF) belong to the most dreaded complications due to the fact that patients’ mortality increases to 20% in the presence of severe, clinically relevant POPF.To improve patient outcome, several reconstruction methods were proposed. Of these, the so called standard Child reconstruction (s-Child), defined as pancreaticojejunostomy (PJ), hepaticojejunostomy (HJ) and gastrojejunostomy (GJ) on the same jejunal loop in this predefined order is among the most commonly used reconstruction methods worldwide. Our recently performed systematic review with meta-analysis led to the hypothesis that morbidity after PD with Child-reconstruction could be successfully reduced by addition of an enteroenterostomy – called Braun enteroenterostomy (BE) between the GJ and the HJ (termed “BE-Child"). Here, BE-Child was associated with a decrease of overall morbidity, reduced rates of POPF and delayed gastric emptying, fewer bile leaks and a shortened length of hospital stay. However, until now, only three randomized-controlled trials (RCT) with a maximum of 36 subjects per study arm were published in the past. Regarding these low number of included patients and the consecutive low power of the studies, a final statement of a possible beneficial effect of an additional BE could not be drawn yet. We therefore plan this randomized controlled trail to evaluate the benefit of BE-Child in patients undergoing PD.
DFG Programme
Clinical Trials
