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Objective assessment of delayed gastric emptying using gastric scintigraphy in post pancreaticoduodenectomy patients
Author(s) -
Samaddar Avishek,
Kaman Lileswar,
Dahiya Divya,
Bhattachyarya Anish,
Sinha Saroj Kant
Publication year - 2017
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.13360
Subject(s) - medicine , gastric emptying , pancreaticoduodenectomy , scintigraphy , gastroenterology , general surgery , stomach , pancreas
Abstract Background No objective assessment of delayed gastric emptying is carried out in patients undergoing W hipple's procedure. All definitions and criteria along with evaluation of incidence of delayed gastric emptying are based on subjective assessment of the patient with clinical overview, so this study was carried out for an objective and accurate assessment of delayed gastric emptying in post W hipple's patients using gastric scintigraphy. Methods Twenty‐one patients undergoing W hipple's procedure performed by a single surgeon in a tertiary referral centre were included in the study. Gastric scintigraphy was performed preoperatively and on post‐operative 10th and 21st days. Preoperative and post‐operative gastric scintigraphy findings were used for the diagnosis of delayed gastric emptying and it was correlated with the incidence of clinical diagnosis of delayed gastric emptying. Results Thirteen out of 21 patients had clinical delayed gastric emptying. When compared with clinical delayed gastric emptying, the sensitivity, specificity, positive and negative predictive values of post‐operative 10th day gastric scintigraphy were 61.53, 100, 100 and 61.53%, respectively ( P = 0.004). The sensitivity, specificity, positive and negative predictive values of post‐operative 21st day gastric scintigraphy were 38.46, 100, 100 and 50%, respectively ( P = 0.04). Reflux across the gastrojejunal anastomosis was noted in 28.5% on dynamic scintigraphy with the severity of clinical symptoms related directly with the degree of reflux. No correlation was seen between delayed gastric emptying and variables such as diabetes mellitus, hypertension and pancreaticojejunal anastomotic leaks. Conclusions Gastric scintigraphy may be used to diagnose delayed gastric emptying more objectively in post W hipple's patients.