Analysis of risk factors and outcomes for delayed gastric emptying following pancreaticoduodenectomy: a single center experience of 492 cases
10.3760/cma.j.issn.0529-5815.2018.01.009
- VernacularTitle: 492例胰十二指肠切除术后胃排空延迟的预后因素分析
- Author:
Jie YIN
1
;
Zipeng LU
;
Kai ZHANG
;
Junli WU
;
Wentao GAO
;
Feng GUO
;
Jianmin CHEN
;
Jishu WEI
;
Pengfei WU
;
Dong XU
;
Kuirong JIANG
;
Yi MIAO
Author Information
1. Pancreas Center, the First Affiliated Hospital with Nanjing Medical University, Nanjing 210029, China
- Publication Type:Journal Article
- Keywords:
Pancreaticoduodenectomy;
Complication;
Delayed gastric emptying;
Pancreatic fistula;
Risk factor
- From:
Chinese Journal of Surgery
2018;56(1):35-40
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate risk factors for delayed gastric emptying(DGE)following pancreaticoduodenectomy(PD).
Methods:There were 492 consecutive patients who underwent PD in Pancreas Center, the First Affiliated Hospital with Nanjing Medical University between January 2012 and December 2014 were identified from a prospective database.There were 315 male and 177 female patients with a median age of 60.5 years.Univariate and multivariate analyses were performed to investigate the independent risk factors for clinically relevant DGE(CR-DGE).
Results:The overall incidence of DGE was 29.5%, with Grade B and C occurring at 4.3% and 5.9%, respectively.In multivariate analysis, pancreatic duct diameter less than 3 mm(OR=1.888, P=0.042), pylorus-preserving pancreaticoduodenectomy(OR=2.627, P=0.005) and clinically relevant postoperative pancreatic fistula(OR=2.740, P=0.007) were independently associated with CR-DGE.Other main complications such as postoperative pancreatic fistula, pyoperitoneum, intraabdominal infection were also associated with the severity of DGE(χ2=21.360, 14.422, 14.378; P=0.011, 0.002, 0.002). DGE patients had a significantly prolonged postoperative length of stay(31(24-41)d vs. 13(11-17)d) and increased medical cost((122 367.5±66 068.3)yuan vs. (78 200.7±27 043.9)yuan)(both P<0.01).
Conclusions:Small pancreatic duct, underwent pylorus-preserving pancreaticoduodenectomy and suffered postoperative pancreatic fistula might indicate a high risk of CR-DGE.
