The Efficacy of Braun Enteroenterostomy in Pancreaticoduodenectomy: A Comprehensive Review

Abstract

Braun enteroenterostomy (BEE) has been increasingly utilized as a reconstructive modification in pancreaticoduodenectomy (PD) to minimize postoperative complications, particularly delayed gastric emptying (DGE). This comprehensive review analyzes evidence from retrospective, prospective, and meta-analytic studies assessing the efficacy of BEE in PD. The findings demonstrate that BEE is associated with a significant reduction in clinically relevant DGE (Grades B/C), shorter hospital stays, and lower overall morbidity compared to conventional reconstructions. Mechanistically, BEE diverts biliary and pancreatic secretions away from the stomach, reducing bile reflux and improving gastric motility. While it marginally increases operative time, the benefits in postoperative recovery and complication reduction outweigh the procedural complexity. Current evidence supports incorporating BEE into standard PD reconstruction, especially within enhanced recovery protocols. However, further randomized controlled trials are warranted to confirm its long-term safety and functional outcomes.