From the Department of General Surgery, Koç Foundation American Hospital.
Pancreas. 2022 May 1;51(5):496-501. doi: 10.1097/MPA.0000000000002057. Epub 2022 Jul 16.
Delayed gastric emptying (DGE) is a complication that affects the length of hospitalization and associated cost after pancreaticoduodenectomy (PD). The reported risk factors for DGE were controversial. This study aimed to identify risk factors for the development of DGE after PD.
The patients who underwent PD between October 2010 and October 2020 were retrospectively examined. Multivariate analysis was performed to predict the variables causing DGE.
In total, 225 patients underwent PD. The pylorus preserving PD was applied to 151 patients (67%), whereas standard PD to 74 (33%). The DGE was detected in 26 patients (11.5%). The majority of cases were classified as grade A (57.7%), whereas 38.4% as grade B and 3.9% as grade C. In the multivariate analysis, diabetes mellitus (odds ratio [OR], 3.48; 95% confidence interval [CI], 1.45-8.34; P = 0.05), the preoperative biliary stent (OR, 2.5; 95% CI, 1.04-5.99; P = 0.039), and the pylorus resection (OR, 3.05; 95% CI, 1.28-7.25; P = 0.012) were independently associated with DGE.
We demonstrated that implementation of the preoperative stent, pylorus resection, and diabetes mellitus are independent risk factors for DGE. Pylorus preservation should remain the standard of care in PD.
胃排空延迟（DGE）是一种影响胰十二指肠切除术后（PD）住院时间和相关费用的并发症。DGE 的报道风险因素存在争议。本研究旨在确定 PD 后发生 DGE 的危险因素。
回顾性检查了 2010 年 10 月至 2020 年 10 月期间接受 PD 的患者。进行多变量分析以预测导致 DGE 的变量。
共有 225 名患者接受了 PD。151 名患者（67%）接受了保留幽门的 PD，74 名患者（33%）接受了标准 PD。26 名患者（11.5%）检测到 DGE。大多数病例被归类为 A 级（57.7%），B 级为 38.4%，C 级为 3.9%。多变量分析显示，糖尿病（优势比 [OR]，3.48；95%置信区间 [CI]，1.45-8.34；P = 0.05）、术前胆道支架（OR，2.5；95% CI，1.04-5.99；P = 0.039）和幽门切除术（OR，3.05；95% CI，1.28-7.25；P = 0.012）与 DGE 独立相关。
我们证明了术前支架、幽门切除术和糖尿病的实施是 DGE 的独立危险因素。保留幽门应仍然是 PD 的标准治疗方法。
