[Influencing factor analysis of delayed gastric emptying after pylorus-preserving pancreaticoduodenectomy].
OBJECTIVE
To investigate the influencing factors of delayed gastric emptying (DGE) after pylorus-preserving pancreaticoduodenectomy (PPPD) and its preventing managements.


METHODS
Forty-two patients who underwent PPPD and 104 patients underwent standard Whipple procedure (SPD) between January 2000 and July 2006 were investigated retrospectively. The factors influencing the development of DGE following PPPD were analyzed statistically.


RESULTS
There was no significant difference in mortality between PPPD and SPD (0/42 vs. 7/104, P = 0.193). Pancreatic fistula occurred much more frequently in SPD than in PPPD (29/104 vs. 1/42, P < 0.05). The occurrence of DGE after PPPD was higher significantly than that after SPD (35.7% vs. 18.3%, P = 0.024). More DGE occurred in patients with a operation time more than 6 hours than in patients whose operation lasted less than 6 hours (76.9% vs. 17.2%, P = 0.008). Meanwhile, DGE occurred in 20% of patients with the antero-colonic route for duodenojejunostomy and in 50% with retro-colonic route (P = 0.043). Multivariate analysis by logistic regression model showed postoperative intra-abdominal complications were not risk factors for DGE. Prophylactic use of somatostatin couldn't prevent DGE effectively.


CONCLUSIONS
DGE is the most frequent postoperative complication after PPPD, it can be markedly reduced by shortening operative time and using antero-colonic duodenojejunostomy procedure. There is no medicine which could prevent DGE effectively.
Gao
Hong-Qiao
HQ
Department of General Surgery, Peking University First Hospital, Beijing 100034, China.
Yang
Yin-Mo
YM
Zhuang
Yan
Y
Wang
Wei-Min
WM
Wu
Wen-Han
WH
Wan
Yuan-Lian
YL
Huang
Yan-Ting
YT
D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D004386:Duodenum / Q000601:surgery; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D007583:Jejunum / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology*; D011708:Pylorus; D012189:Retrospective Studies; D012307:Risk Factors; D013272:Stomach Diseases / Q000209:etiology / Q000503:physiopathology*