title: Factors influencing delayed gastric emptying after pancreaticoduodenectomy - a meta-analysis.
abstract: OBJECTIVE
  Delayed gastric emptying (DGE) is the most frequent postoperative complication after pancreaticoduodenectomy. Not only does it contribute considerably to prolonged hospitalization, but it is also associated with increased postoperative morbidity and mortality. We performed a meta-analysis to assess factors influencing the development of DGE after pancreaticoduodenectomy.
  
  
  METHODS
  We systematically searched for studies that assessed association between peri-operative factors and DGE. We reviewed separately each of the factors, including preservation of pylorus, methods of gastrointestinal reconstruction, postoperative enteral feeding and postoperative complications. We identified 1035 studies published between May 1, 1988 and May 1, 2008.
  
  
  RESULTS
  Compared with control subjects, the risk of DGE was 2.35 for preservation of pylorus (95% CI, 0.72 to 7.61), 6.14 for postoperative complications (95% CI, 3.47 to 10.85). There was no significant association between the occurrence of DGE with either PD or PPPD.
  
  
  CONCLUSIONS
  Postoperative enteral feeding did not show any advantages in preventing DGE. Postoperative complications were the most important factor associated with DGE’s occurrence. Antecolic and BII type gastrojejunostomy seems to suggest an improvement in the incidence of DGE.
authors.forename: Hao-Lin
authors.initials: HL
authors.lastname: Hu
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Zhou
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Xin
authors.initials: X
authors.lastname: Shi
mesh_terms: D016009:Chi-Square Distribution; D004750:Enteral Nutrition; D005746:Gastric Emptying; D018589:Gastroparesis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D016017:Odds Ratio; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome