Delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy.
OBJECTIVE
Pylorus-preserving pancreaticoduodenectomy is associated with a high incidence of delayed gastric emptying. The aim of this study was to determine the incidence and risk factors for delayed gastric emptying after this procedure.


METHODS
This retrospective study included 63 consecutive patients who received pylorus-preserving pancreaticoduodenectomy from July 1993 to December 2002. The patients were divided into 2 groups based on the presence of delayed gastric emptying. Preoperative indices, postoperative morbidity, nasogastric intubation, and hospital stay were compared. The risk factors for delayed gastric emptying were analyzed.


RESULTS
The postoperative incidence of delayed gastric emptying was 44% (28/63 patients). Multivariate analysis revealed that no preoperative biliary drainage, no cholestatic change in the liver and blood loss > 400 mL were significant risk factors for delayed gastric emptying.


CONCLUSIONS
Pylorus-preserving pancreaticoduodenectomy is a safe procedure with a high incidence of delayed gastric emptying. Delicate surgical dissection to decrease blood loss and the extent of perigastric inflammation may be the key factor to prevent delayed gastric emptying.
Department of Surgery, National Cheng Kung University Hospital, Tainan, Taiwan.
Yan-Shen
YS
Shan
Yu-Hsiang
YH
Hsieh
Edgar D
ED
Sy
Pin-Wen
PW
Lin
D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods*; D011708:Pylorus / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors