Abstract
ABSTRACT Background:The delay in gastric emptying is the second most frequent complication after duodenopancreatectomy with pyloric preservation, that increases hospitalization time and hospital costs. Aim:To identify factors that contribute to the appearance the delay in this surgical procedure. Method:Ninety-five patients were submitted to duodenopancreatectomy with pyloric preservation. After retrospective analysis of the medical records, it was observed that 60 had prolonged hospitalization due to complications. Thus, univariate and multivariate logistic regression were used to analyze predictors of delayed gastric emptying. Results:Delay was present in 65% (n=39) and pancreatic fistula in 38.3% (n=23). Univariate analysis revealed that the presence of pancreatic complications (pancreatic fistula, p=0.01), other intracavitary complications with the appearance of abdominal collections (p=0.03) and hypoalbuminemia (p=0.06) were responsible, also confirmed by the multivariate analysis. In those who presented delay without a determined cause, it was observed that high levels of total bilirubin (p=0.01) and direct bilirubin (p=0.01) could be related to it. Conclusion:The delay in gastric emptying in patients undergoing duodenopancreatectomy with pyloric preservation is due to intracavitary complications.
Highlights
In high-volume centers for pancreatic operations, mortality rates are less than 5%29
GED occurs after pyloric-sparing duodenopancreatectomy (PPPD), in the Whipple procedure and in distal pancretectomies[16]
Complications rates, mortality and reoperation of PPPDs performed in the period were studied
Summary
In high-volume centers for pancreatic operations, mortality rates are less than 5%29. Delayed gastric emptying (GED) is defined as the patient’s inability to tolerate the oral diet until the end of the first week after pancreatic surgery[29]. It is a relatively common complication after pancreaticoduodenectomy and may occur in up to 40%12. Despite the low mortality rate resulting from it, its occurrence is associated with prolonged hospital stay and high costs[1]. GED occurs after pyloric-sparing duodenopancreatectomy (PPPD), in the Whipple procedure and in distal pancretectomies[16]. The aim of this study was to identify factors related to GED after PPPD
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