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Risk factors for delayed gastric emptying after pancreatoduodenectomy
Author(s) -
Chong Charing ChingNing,
Lee KitFai,
Ip Philip ChingTak,
Liu Shirley YukWah,
Chan Micah ChiKing,
Cheung YueSun,
Wong John,
Lai Paul BoSan
Publication year - 2015
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12100
Subject(s) - medicine , gastric emptying , pancreaticoduodenectomy , pancreatic fistula , incidence (geometry) , pleural effusion , gastroenterology , demographics , grading (engineering) , surgery , general surgery , stomach , pancreas , physics , demography , civil engineering , sociology , optics , engineering
Aim Evaluation of the prevalence of delayed gastric emptying ( DGE ) post‐operatively is thwarted by an inconsistency in DGE definition. The aim of the present study was to evaluate the incidence and underlying risk factors of DGE after pancreaticoduodenectomy (PD), employing the International Group of Pancreatic Surgery ( ISGPS ) consensus definition. Patients and Methods Patient demographics, operative details, clinical course and pathology of 95 consecutive patients who underwent PD at a tertiary academic institution were analysed. Results The overall incidence of DGE was 32.6 per cent, and those of grades A , B and C were 18.9 per cent, 5.3 per cent and 8.4 per cent, respectively. DGE was associated with longer post‐operative length of stay (17 days vs 13 days, P = 0.016). With increasing DGE severity, there was a statistically‐significant increase in the presence of post‐operative pancreatic fistula greater than grade A ( P = 0.033) and the post‐operative length of stay ( P = 0.020). Post‐operative pleural effusion ( P = 0.020) and increased number of lymph nodes resected ( P = 0.014) are significant independent risk factors for DGE . Conclusions The ISGPS definition and grading systems for DGE are applicable and correlate well with clinical course. An association between more extensive lymphatic dissection and DGE is noted.