title: Value of scintigraphy for assessing delayed gastric emptying after pancreatic surgery.
abstract: BACKGROUND
  Delayed gastric emptying (DGE) occurs frequently after pancreatic surgery. Recently a consensus definition of DGE was introduced, and this grading system is currently widely used. The aim of this study was to compare results of gastric emptying scintigraphy with the grade of DGE after pancreatic surgery.
  
  
  METHODS
  In 44 patients undergoing exploration for a pancreatic head or periampullary tumor, 28 pancreatoduodenectomies (PDs) and 16 double-bypass procedures were performed. All patients underwent preoperative and postoperative gastric emptying scintigraphy. We investigated whether the incidence of DGE was correlated with the results of gastric emptying scintigraphy.
  
  
  RESULTS
  DGE occurred in 19 (43 %) patients. Clinically relevant DGE (grades B and C) prevailed in the PD group. Median postoperative residual activity at t = 2 h (%RA120) in these groups was 36 % (no DGE), 75 % (grade A), 93 % (grade B), and 95 % (grade C). DGE grade B or C was found in 7 of 10 patients with %RA120 of ≥94 % on postoperative day (POD) 7.
  
  
  CONCLUSIONS
  Postoperative %RA120 on scintigraphy is positively associated with severity of DGE. Gastric emptying scintigraphy on POD 7 can predict the severity of DGE. When postoperative gastric emptying scintigraphy shows high residual radioactivity, the likelihood of further progression to grade B or C DGE is high and warrants investigation for underlying causes.
authors.forename: Gan
authors.initials: G
authors.lastname: van Samkar
authors.forename: Wietse J
authors.initials: WJ
authors.lastname: Eshuis
authors.forename: Marike
authors.initials: M
authors.lastname: Lemmers
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: Roel J
authors.initials: RJ
authors.lastname: Bennink
authors.forename: Markus W
authors.initials: MW
authors.lastname: Hollmann
authors.forename: Marcel G W
authors.initials: MG
authors.lastname: Dijkgraaf
authors.forename: Olivier R  C
authors.initials: OR
authors.lastname: Busch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D018589:Gastroparesis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011877:Radionuclide Imaging; D012720:Severity of Illness Index; D016896:Treatment Outcome