BACKGROUND: The factors associated with delayed gastric emptying (DGE) after a pancreaticoduodenectomy (PD) are not definitively known. METHODS: From November 2011 through to May 2012, data were prospectively collected on 711 patients undergoing a pancreaticoduodenectomy or total pancreatectomy as part of the American College of Surgeons-National Surgical Quality Improvement Program Pancreatectomy Demonstration Project. Bivariate and multivariate models were employed to determine the factors that predicted DGE. RESULTS: In the 711 patients, the overall rate of DGE was 20.1%. In a bivariate analysis, intra-operative factors such as pylorus-preservation (47.1% versus 43.7%, P = 0.40), intra-operative drain placement (85.5%, versus 85.1%, P = 0.91) and an antecolic compared with a retrocolic gastrojejunostomy (60.1% versus 65.1%, P = 0.26) were not different between the DGE and no DGE groups. Pancreatic fistula formation (31.2% versus 10.1%), post-operative sepsis (21.7% versus 7.0%), organ space surgical site infection (SSI) (23.9% versus 7.9%), need for percutaneous drainage (23.0% versus 10.6%) and reoperation (10.6% versus 3.1%) were higher in patients with DGE (P < 0.0001). In a multivariable model, only pancreatic fistula, post-operative sepsis and reoperation were independently associated with DGE. DISCUSSION: In this multicentre study, only post-operative complications were associated with DGE. Neither pylorus preservation nor route of enteric reconstruction (antecolic versus retrocolic) was associated with delayed gastric emptying.
BACKGROUND: The factors associated with delayed gastric emptying (DGE) after a pancreaticoduodenectomy (PD) are not definitively known. METHODS: From November 2011 through to May 2012, data were prospectively collected on 711 patients undergoing a pancreaticoduodenectomy or total pancreatectomy as part of the American College of Surgeons-National Surgical Quality Improvement Program Pancreatectomy Demonstration Project. Bivariate and multivariate models were employed to determine the factors that predicted DGE. RESULTS: In the 711 patients, the overall rate of DGE was 20.1%. In a bivariate analysis, intra-operative factors such as pylorus-preservation (47.1% versus 43.7%, P = 0.40), intra-operative drain placement (85.5%, versus 85.1%, P = 0.91) and an antecolic compared with a retrocolic gastrojejunostomy (60.1% versus 65.1%, P = 0.26) were not different between the DGE and no DGE groups. Pancreatic fistula formation (31.2% versus 10.1%), post-operative sepsis (21.7% versus 7.0%), organ space surgical site infection (SSI) (23.9% versus 7.9%), need for percutaneous drainage (23.0% versus 10.6%) and reoperation (10.6% versus 3.1%) were higher in patients with DGE (P < 0.0001). In a multivariable model, only pancreatic fistula, post-operative sepsis and reoperation were independently associated with DGE. DISCUSSION: In this multicentre study, only post-operative complications were associated with DGE. Neither pylorus preservation nor route of enteric reconstruction (antecolic versus retrocolic) was associated with delayed gastric emptying.
Authors: M W Müller; H Friess; H G Beger; J Kleeff; B Lauterburg; B Glasbrenner; R L Riepl; M W Büchler Journal: Am J Surg Date: 1997-04 Impact factor: 2.565
Authors: Irene Epelboym; Irmina Gawlas; James A Lee; Beth Schrope; John A Chabot; John D Allendorf Journal: World J Surg Date: 2014-06 Impact factor: 3.352
Authors: Jashodeep Datta; Russell S Lewis; Steven M Strasberg; Bruce L Hall; John D Allendorf; Joal D Beane; Stephen W Behrman; Mark P Callery; John D Christein; Jeffrey A Drebin; Irene Epelboym; Jin He; Henry A Pitt; Emily Winslow; Christopher Wolfgang; Major K Lee; Charles M Vollmer Journal: J Gastrointest Surg Date: 2014-12-02 Impact factor: 3.452
Authors: Joshua D Eisenberg; Ernest L Rosato; Harish Lavu; Charles J Yeo; Jordan M Winter Journal: J Gastrointest Surg Date: 2015-07-14 Impact factor: 3.452
Authors: Jamie R Robinson; Paula Marincola; Julia Shelton; Nipun B Merchant; Kamran Idrees; Alexander A Parikh Journal: HPB (Oxford) Date: 2015-02-28 Impact factor: 3.647
Authors: Nina P Tamirisa; Abhishek D Parmar; Gabriela M Vargas; Hemalkumar B Mehta; E Molly Kilbane; Bruce L Hall; Henry A Pitt; Taylor S Riall Journal: Ann Surg Date: 2016-02 Impact factor: 12.969
Authors: Amanda B Cooper; Abhishek D Parmar; Taylor S Riall; Bruce L Hall; Matthew H G Katz; Thomas A Aloia; Henry A Pitt Journal: J Gastrointest Surg Date: 2014-08-05 Impact factor: 3.452
Authors: Daniel P Nussbaum; Sabino Zani; Kara Penne; Paul J Speicher; Sandra S Stinnett; Bryan M Clary; Rebekah R White; Douglas S Tyler; Dan G Blazer Journal: J Gastrointest Surg Date: 2014-06-25 Impact factor: 3.452