{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:03:28Z","timestamp":1788879808594,"version":"build-2803163510"},"reference-count":40,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T00:00:00Z","timestamp":1736467200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>There is controversy regarding which is the best reconstruction technique after the pancreatoduodenectomy. Currently, there are no studies comparing the three most frequent reconstruction techniques: Whipple\u2009+\u2009Roux-en-Y gastrojejunostomy (WRYGJ), pyloric-preserving\u2009+\u2009Billroth II (PPBII), and Whipple\u2009+\u2009BII (WBII).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Between 2012 and March 2023, 246 patients underwent pancreaticoduodenectomy with the following type of reconstruction techniques: (1) WRYGJ: 40 patients; (2) PPBII: 118 patients; and (3) WBII: 88 patients. A retrospective comparative study among these groups was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>No significant differences were found among the groups regarding duration of the surgery, the blood volume transfused, or caliber of the Wirsung duct. The size and types of tumors, the degree of differentiation and tumor invasion of the peripancreatic tissue, vascular and neural structures, and lymph nodes were similar among the groups. The rate of R0 resection was lower in WBII (62.5% [55\/88]) than in WRYGJ (75% [30\/40]) and PPBII (72% [85\/118]), but statistically insignificant among the groups (p\u2009=\u20090.232). The incidences of relevant B\/C postoperative pancreatic fistula (POPF) were similar among the groups: 7.5% (7\/40) in WRYGJ, 17% (20\/118) in PPBI, and 26.2% (23\/88) in WBII (p\u2009=\u20090.292). In addition, the incidence of B\/C delayed gastric emptying (DGE) was higher in WBII (27.3% [24\/88]) than in WRYGJ (20% [8\/40]) and PPBII (19.5% [23\/118]) but statistically insignificance among the groups (p\u2009=\u20090.381). The incidence of medical and surgical complications, intensive care unit and hospital stays, morbimortality at 90\u2009days, and 5-year survival were similar among the groups. Multivariate analysis revealed that POPF grade B\/C was a risk factor for DGE grade B\/C (odds ratio (OR)\u2009=\u20099.903, 95% confidence interval (CI)\u2009=\u20094.829\u201320.310; p\u2009&lt;\u20090.001), and a &lt;3-mm Wirsung duct was a risk factor for POPF (OR\u2009=\u20093.604, 95% CI\u2009=\u20091.791\u20137.254; p\u2009&lt;\u20090.001).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>No technique was superior to the others. Only relevant POPF B\/C was a risk factor for DGE B\/C, and &lt;3\u2009mm Wirsung for a POPF.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969241312287","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T06:27:48Z","timestamp":1736490468000},"page":"183-193","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of reconstruction techniques after pancreatoduodenectomy: A single-center retrospective cohort study"],"prefix":"10.1177","volume":"114","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0553-5835","authenticated-orcid":false,"given":"Iago","family":"Justo Alonso","sequence":"first","affiliation":[{"name":"Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, \u201cDoce de Octubre University Hospital,\u201d Instituto de Investigaci\u00f3n (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola","family":"Peralta Fern\u00e1ndez-Revuelta","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, \u201cDoce de Octubre University Hospital,\u201d Instituto de Investigaci\u00f3n (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Marcacuzco Quinto","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, \u201cDoce de Octubre University Hospital,\u201d Instituto de Investigaci\u00f3n (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar","family":"Caso Maestro","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, \u201cDoce de Octubre University Hospital,\u201d Instituto de Investigaci\u00f3n (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Alonso Murillo","sequence":"additional","affiliation":[{"name":"Unit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation, \u201cDoce de Octubre University Hospital,\u201d Instituto de Investigaci\u00f3n (imas12), Department of Surgery, Faculty of Medicine, Complutense University, Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Jim\u00e9nez-Romero","sequence":"additional","affiliation":[{"name":"Carlos Jim\u00e9nez-RomeroUnit of Hepato-Pancreato-Biliary Surgery and Abdominal Organ Transplantation \u201cDoce de Octubre University Hospital\u201d Department of Surgery Faculty of Medicine Complutense University 6th Floor Carretera Andaluc\u00eda Km 5,4 28041 Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,10]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3109\/08941939.2015.1105327"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.10160"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hpb.2018.06.1795"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31821219af"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2018.06.033"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9544"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/hpb.12385"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.21037\/gs-21-645"},{"key":"e_1_3_3_10_2","first-page":"271","article-title":"A modified technique for the reconstruction of the alimentary tract after pancreaticoduodenectomy","volume":"143","author":"Machado MC","year":"1976","unstructured":"Machado MC, da Cunha JE, Bacchella T, et al: A modified technique for the reconstruction of the alimentary tract after pancreaticoduodenectomy. Surg Gynecol Obstet 1976;143:271\u2013272.","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2008.04.007"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2009.00051.x"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2013.02.008"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9703"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31826c3f90"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-016-3091-5"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.4240\/wjgs.v11.i2.93"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.11023"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/AS9.0000000000000161"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2021.105923"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00423-022-02583-9"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e31820d98f1"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0090316"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000002480"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.asjsur.2020.08.012"},{"issue":"6","key":"e_1_3_3_26_2","first-page":"440","article-title":"Pancreaticoduodenectomy and external Wirsung stenting: Our outcomes in 80 cases","volume":"99","author":"Jim\u00e9nez Romero C","year":"2021","unstructured":"Jim\u00e9nez Romero C, Alonso Murillo L, Rioja Conde P, et al: Pancreaticoduodenectomy and external Wirsung stenting: Our outcomes in 80 cases. Cir Esp 2021;99(6):440\u2013449.","journal-title":"Cir Esp"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.05.005"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2016.11.014"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2007.02.001"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b13ca2"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s002689900084"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-005-1085-x"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2795-2"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-007-9388-5"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.8654"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2012.09.002"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-015-2884-2"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000000048"},{"key":"e_1_3_3_39_2","doi-asserted-by":"publisher","DOI":"10.1002\/jhbp.828"},{"key":"e_1_3_3_40_2","article-title":"Pylorus-preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment of periampullary and pancreatic carcinoma","volume":"2","author":"H\u00fcttner FJ","year":"2016","unstructured":"H\u00fcttner FJ, Fitzmaurice C, Schwarzer G, et al: Pylorus-preserving pancreaticoduodenectomy (pp Whipple) versus pancreaticoduodenectomy (classic Whipple) for surgical treatment of periampullary and pancreatic carcinoma. Cochrane Database Syst Rev 2016;2:CD006053.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_3_41_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12957-018-1467-6"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969241312287","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14574969241312287","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969241312287","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:59:55Z","timestamp":1777697995000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14574969241312287"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,10]]},"references-count":40,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1177\/14574969241312287"],"URL":"https:\/\/doi.org\/10.1177\/14574969241312287","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,10]]}}}