Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy.
OBJECTIVE
The mechanism of delayed gastric emptying following pylorus-preserving pancreaticoduodenectomy is not completely understood.


METHODS
The records of 25 patients who underwent pylorus-preserving pancreaticoduodenectomy were reviewed. Correlations of postoperative delayed gastric emptying defined as the need for postoperative nasogastric decompression for > 10 days, with perioperative parameters and clinical outcome were analyzed.


RESULTS
Delayed gastric emptying occurred in 13 patients. Age, gender, presence of pancreatic carcinoma, operating time, estimated blood loss, and preservation of right gastric artery did not affect the incidence of delayed gastric emptying. Patients with pancreatic fibrosis (n = 13) had a significantly lower incidence of delayed gastric emptying than in those without fibrosis (n = 12) (23% vs. 83%, P = 0.0048). Ten patients developed postoperative septic complications, including anastomotic leakage (n = 7), pneumonia (n = 2), and severe wound infection (n = 1). The incidence of postoperative delayed gastric emptying was significantly higher in patients with septic complications than in those without septic complications (100% vs. 20%, P = 0.0001). Also, patients with intraabdominal sepsis had a significantly higher incidence of delayed gastric emptying (P = 0.0052).


CONCLUSIONS
Delayed gastric emptying following pylorus-preserving pancreaticoduodenectomy is related to the presence of non-fibrotic pancreas and postoperative septic complications.
Kimura
Fumio
F
Department of Surgery, Omiya Red Cross Hospital, 8-3-33 Kamiochiai, Yono, Saitama 338-8553, Japan. lionkim@pop01.odn.ne.jp
Suwa
Toshikazu
T
Sugiura
Toshiyuki
T
Shinoda
Tokuzou
T
Miyazaki
Masaru
M
Itoh
Hiroshi
H
D000230:Adenocarcinoma / Q000601:surgery; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D010195:Pancreatitis / Q000601:surgery; D011184:Postoperative Period; D012189:Retrospective Studies; D018805:Sepsis / Q000503:physiopathology*