Risk factors for delayed gastric emptying after pancreaticoduodenectomy

Abstract

Objective To analyze the related risk factors for delayed gastric emptying (DGE) after pancreaticoduodenectomy. Methods Clinical data on 308 patients who underwent pancreaticoduodenectomy at Ningbo Lihuili hospital from January 2009 to December 2014 were retrospectively analyzed, and patients were divided into DGE group and non-DGE group. Univariate analysis and multivariate logistic regression analysis were used to study the risk factors associated with DGE during perioperative period. Results DGE occurred in 55 patients (17.9%). The incidences of grade A, grade B and grade C DGE were 7.1%(22/308), 6.2%(19/308) and 4.5%(14/308), respectively. The univariate analysis showed the method of pancreatic digestive tract reconstruction (pancreaticogastrostomy or pancreaticojejunostomy), postoperative pancreatic fistula, postoperative biliary fistula and postoperative intraabdominal infection were risk factors for DGE after surgery. Multivariate analysis indicated that the method of pancreatic digestive tract reconstruction (OR=1.19, P=0.046), postoperative pancreatic fistula (OR=1.33, P=0.014), postoperative biliary fistula (OR=1.43, P=0.047) and postoperative intraabdominal infection (OR=1.51, P=0.001) were independently associated with DGE. Postoperative pancreatic fistula (OR=3.692, P=0.021)and intraabdominal infection (OR=3.725, P=0.003)were also the independent risk factors for Grade B and Grade C DGE. Conclusions DGE after pancreaticoduodenectomy was strongly related to the postoperative complications. Postoperative pancreatic fistula, biliary fistula and intraabdominal infection were associated with increased risk of DGE, while pancreaticogastrostomy reduced the incidence of DGE by decreasing the incidence of pancreatic or biliary fistula. Key words: Pancreaticoduodenectomy; Delayed gastric emptying; Postoperative complications; Risk factors