Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial.

results of short-term outcomes, for overall pooled analysis suggested favorable 30-day mortality in PVI group but the pooled results of well-matched cohorts indicated comparable outcomes between PVI and BSX groups. However, as for long-term outcomes, the pooled analysis of matched cohorts supported our findings in overall analysis, which further confirmed the robustness of our results. In summary, we appreciate Dr Sharath et al for pointing out several interesting issues that might warrant the attention of future researchers. Despite the lacking of related RCT, the clinical significance of current evidence cannot be ignored and the pooled results with matching sensitivity analysis may shed light on the selection of PVI and BSX in CLI patients, while waiting for the results of future RCTs. We hope that our study encourages more vascular surgeons and radiologist to continue exploring the optimal first-line choice of intervention in CLI patients.

[1]  M. Büchler,et al.  Pylorus Resection Does Not Reduce Delayed Gastric Emptying After Partial Pancreatoduodenectomy: A Blinded Randomized Controlled Trial (PROPP Study, DRKS00004191) , 2017, Annals of surgery.

[2]  Yazhou He,et al.  Percutaneous Vascular Interventions Versus Bypass Surgeries in Patients With Critical Limb Ischemia: A Comprehensive Meta-analysis , 2017, Annals of surgery.

[3]  M. Uematsu,et al.  Comparison of Clinical Outcomes after Surgical and Endovascular Revascularization in Hemodialysis Patients with Critical Limb Ischemia , 2017, Journal of atherosclerosis and thrombosis.

[4]  M. Borowski,et al.  Endovascular Therapy Versus Bypass Surgery as First-Line Treatment Strategies for Critical Limb Ischemia: Results of the Interim Analysis of the CRITISCH Registry. , 2016, JACC. Cardiovascular interventions.

[5]  K. Katsanos,et al.  Comparison of angioplasty and bypass surgery for critical limb ischaemia in patients with infrapopliteal peripheral artery disease , 2016, The British journal of surgery.

[6]  M. Büchler,et al.  No Need for Routine Drainage After Pancreatic Head Resection: The Dual-Center, Randomized, Controlled PANDRA Trial (ISRCTN04937707) , 2016, Annals of surgery.

[7]  O. Iida,et al.  Propensity Score Analysis of Clinical Outcome After Bypass Surgery vs. Endovascular Therapy for Infrainguinal Artery Disease in Patients With Critical Limb Ischemia , 2014, Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists.

[8]  M. Büchler,et al.  Pylorus resection or pylorus preservation in partial pancreatico-duodenectomy (PROPP study): study protocol for a randomized controlled trial , 2013, Trials.

[9]  April E. Nedeau,et al.  Results for primary bypass versus primary angioplasty/stent for intermittent claudication due to superficial femoral artery occlusive disease. , 2012, Journal of vascular surgery.

[10]  H. Yamaue,et al.  Pylorus Ring Resection Reduces Delayed Gastric Emptying in Patients Undergoing Pancreatoduodenectomy: A Prospective, Randomized, Controlled Trial of Pylorus-Resecting Versus Pylorus-Preserving Pancreatoduodenectomy , 2011, Annals of surgery.

[11]  R. Rutherford Reporting standards for endovascular surgery: should existing standards be modified for newer procedures? , 1997, Seminars in vascular surgery.

[12]  Karl E. Peace,et al.  Intention to treat in clinical trials , 1989 .