Supplementary Material for: The Vertical Array Reconstruction Technique in Pylorus-Preserving Pancreatoduodenectomy

<b><i>Background/Aims:</i></b> We describe a new reconstruction method of duodenojejunal anastomosis, the “vertical array reconstruction” (VAR) technique, following pylorus-preserving pancreatoduodenectomy (PPPD). <b><i>Methods:</i></b> The VAR technique aligns the stomach, duodenum, and jejunal loop vertically along the body’s longitudinal axis. It was performed in 120 consecutive patients (between June 2008 and October 2015) who underwent PPPD. We evaluated the incidence of delayed gastric emptying (DGE). <b><i>Results:</i></b> The incidence of DGE was 1.7% (<i>n</i> = 2). The proposed clinical grading classified these 2 cases of DGE as grade B. There was no DGE related to pancreatic fistula. The median duration to starting a solid diet was 3 days (range 3–5 days). The median operative time was 450 min (range 391–550 min). <b><i>Conclusion:</i></b> The VAR technique allows the upper digestive tract to be aligned linearly and can minimize the risk of DGE after PPPD.

<b><i>背景与目的：</i></b> 本研究报道一种应用于保留幽门胰十二指肠切除术（pylorus-preserving pancreatoduodenectomy, PPPD）后的新型十二指肠空肠吻合重建术式——“垂直阵列重建术（vertical array reconstruction, VAR）”。<b><i>方法：</i></b> VAR术式将胃、十二指肠及空肠袢沿人体纵轴垂直对齐排布。本研究纳入2008年6月至2015年10月期间接受PPPD的120例连续入组患者，并对其术后胃排空延迟（delayed gastric emptying, DGE）的发生率进行评估。<b><i>结果：</i></b> 本研究中DGE发生率为1.7%（<i>n</i>=2）。依据本研究采用的临床分级标准，该2例DGE均被归为B级。未出现与胰瘘相关的DGE病例。患者开始进食固体食物的中位时间为3天（范围3~5天）；手术中位时长为450分钟（范围391~550分钟）。<b><i>结论：</i></b> VAR术式可使上消化道呈线性对齐排布，能够降低PPPD术后DGE的发生风险。