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Impact of delayed gastric emptying after pancreaticoduodenectomy on survival
Author(s) -
Futagawa Yasuro,
Kanehira Masaru,
Furukawa Kenei,
Kitamura Hiroaki,
Yoshida Seiya,
Usuba Teruyuki,
Misawa Takeyuki,
Okamoto Tomoyoshi,
Yanaga Katsuhiko
Publication year - 2017
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.482
Subject(s) - pancreaticoduodenectomy , medicine , gastroenterology , hazard ratio , confidence interval , ampulla of vater , gastric emptying , pancreatic cancer , proportional hazards model , bile duct cancer , complication , cancer , pancreas , stomach , carcinoma
Background Delayed gastric emptying ( DGE ), a common postoperative complication of pancreaticoduodenectomy, is not considered a life‐threatening complication. In the present study, we analyzed the risk factors for DGE and its impact on long‐term prognosis. Methods We analyzed 383 patients who underwent pancreaticoduodenectomy between 2003 and 2010, dividing them into two groups according to DGE grade as defined by the International Study Group of Pancreatic Surgery: 243 without DGE (non‐ DGE group) and 140 with DGE of any grade ( DGE group). Results The 5‐year overall survival was 32.7% in the DGE group, and 41% in the non‐ DGE group ( P = 0.02). Cox proportional hazards analyses showed that pancreatic cancer (compared with ampulla of Vater cancer: hazard ratio [ HR ] 3.4, 95% confidence interval [ CI ] 1.82–6.34, P < 0.001), bile duct cancer ( HR 2.1, 95% CI 1.08–4.06, P = 0.03), the Union for International Cancer Control stage (compared with stages I and II : HR 2.98, 95% CI 1.66–5.35, P < 0.001; compared with stage III : HR 4.71, 95% CI 2.51–8.86, P < 0.001), and DGE grade (grade C; HR 1.6, 95% CI 1.04–2.46, P = 0.03) were independent risk factors for cancer‐specific survival. Conclusions DGE , especially grade C, negatively affects cancer‐specific survival.