Abstract
BackgroundAtrial fibrillation and delayed gastric emptying (DGE) are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7th postoperative day.MethodsWe performed a retrospective chart review of 249 patients who underwent pancreaticoduodenectomy at our institution between 2000 and 2009. Data was analyzed with Fisher exact test for categorical variables and Mann-Whitney U or unpaired T-test for continuous variables.ResultsApproximately 5% of the 249 patients included in the analysis experienced at least one episode of postoperative atrial fibrillation. Median age of patients with atrial fibrillation was 74 years, compared with 66 years in patients without atrial fibrillation (p = 0.0005). Patients with atrial fibrillation were more likely to have a history of atrial fibrillation (p = 0.03). 92% of the patients with atrial fibrillation suffered from DGE, compared to 46% of patients without atrial fibrillation (p = 0.0007). This association held true when controlling for age.ConclusionPatients with postoperative atrial fibrillation are more likely to experience delayed gastric emptying. Interventions to manage delayed gastric function might be prudent in patients at high risk for postoperative atrial fibrillation.
Highlights
Atrial fibrillation and delayed gastric emptying (DGE) are common after pancreaticoduodenectomy (Whipple procedure) [1]
The most common supraventricular arrhythmia observed was atrial fibrillation; postoperative supraventricular arrhythmia was associated with a 33% increase in length of stay
Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which, in keeping with ISGPS criteria, we defined as failure to tolerate a regular diet by the 7th postoperative day [3]
Summary
Atrial fibrillation and delayed gastric emptying (DGE) are common after pancreaticoduodenectomy (Whipple procedure) [1]. Postoperative atrial fibrillation is associated with increased morbidity and mortality, as well as prolonged hospital stay, which taxes staff and resources [2]. The most common supraventricular arrhythmia observed was atrial fibrillation; postoperative supraventricular arrhythmia was associated with a 33% increase in length of stay. Patients with postoperative supraventricular arrhythmias were found to be at significantly increased risk of cerebrovascular accident, pulmonary embolism and gastrointestinal bleeding [2]. Atrial fibrillation and delayed gastric emptying (DGE) are common after pancreaticoduodenectomy. Our aim was to investigate a potential relationship between atrial fibrillation and DGE, which we defined as failure to tolerate a regular diet by the 7th postoperative day
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