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World Journal of Surgery
Published in: World Journal of Surgery 4/2014

01-04-2014

Factors Influencing Clinically Significant Delayed Gastric Emptying After Subtotal Stomach-Preserving Pancreatoduodenectomy

Authors: Go Sato, Yoichi Ishizaki, Jiro Yoshimoto, Hiroyuki Sugo, Hiroshi Imamura, Seiji Kawasaki

Published in: World Journal of Surgery | Issue 4/2014

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Abstract

Background

Subtotal stomach-preserving pancreatoduodenectomy (SSPPD), in which the pylorus ring is resected and most of the stomach is preserved, has been performed recently in Japan. This study was undertaken to clarify the incidence of delayed gastric emptying (DGE) after SSPPD at a high-volume hospital and to determine the independent factors that influence the development of DGE after SSPPD.

Methods

Between 2002 and 2011, 201 consecutive patients underwent standardized SSPPD. After SSPPD, DGE (defined according to the International Study Group of Pancreatic Surgery) was analyzed, and associated variables were assessed by univariate and multivariate analyses, retrospectively.

Results

Clinically significant DGE (grades B and C) occurred in 35 (17 %) of the 201 patients; 26 patients had other accompanying abdominal complications (secondary DGE), and pancreatic leakage was the sole risk factor for DGE (odds ratio 6.63, 95 % CI 2.86–15.74; p < 0.001). Only nine (4 % of all patients) of the 35 patients with clinically significant DGE were classified as having DGE that had arisen without any obvious etiology (primary DGE).

Conclusions

DGE after SSPPD is strongly linked to the occurrence of other postoperative intra-abdominal complications such as pancreatic fistula. The incidence rate of primary DGE after SSPPD was 4 %. Although the ISGPS classification of DGE is clearly applicable, the grades do not explain why DGE occurs. Primary and secondary DGE should therefore be defined separately.
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Metadata
Title
Factors Influencing Clinically Significant Delayed Gastric Emptying After Subtotal Stomach-Preserving Pancreatoduodenectomy
Authors
Go Sato
Yoichi Ishizaki
Jiro Yoshimoto
Hiroyuki Sugo
Hiroshi Imamura
Seiji Kawasaki
Publication date
01-04-2014
Publisher
Springer US
Published in
World Journal of Surgery / Issue 4/2014
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-013-2288-y

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