title: Delayed gastric emptying after pancreaticoduodenectomy. Risk factors, predictors of severity and outcome. A single center experience of 588 cases.
abstract: BACKGROUND
  Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy (PD). This study was designed to evaluate perioperative risk variables for DGE after PD and analyze the factors that predict its severity.
  
  
  METHODS
  Demographic data, preoperative, intraoperative, and postoperative variables were collected.
  
  
  RESULTS
  A total of 588 consecutive patients underwent PD. One hundred and five patients (17.9 %) developed DGE of any type. Forty-three patients (7.3 %) had a type A, 53 patients (9.01 %) had DGE type B, and the remaining nine patients (1.5 %) had DGE type C. BMI > 25, diabetes mellitus (DM), preoperative biliary drainage, retrocolic reconstruction, type of pancreatic reconstruction, presence of complications, postoperative pancreatic fistula (POPF), and bile leaks were significantly associated with a higher incidence of DGE. Thirty-three (31.4 %) patients were diagnosed as primary DGE, while 72 (68.5 %) patients had DGE secondary to concomitant complications. Type B and C DGE were significantly noticed in secondary DGE (P = 0.04). Hospital stay was significantly shorter in primary DGE.
  
  
  CONCLUSIONS
  Retrocolic GJ, DM, presence of complications, type of pancreatic reconstruction, and severity of POPF were independent significant risk factors for development of DGE. Type B and C DGE were significantly more in secondary DGE.
authors.affiliation: Mansoura University, Gastroenterology Surgical Center, Mansoura, Egypt, elnakeebayman@yahoo.com.
authors.forename: Ayman
authors.initials: A
authors.lastname: El Nakeeb
authors.forename: Waleed
authors.initials: W
authors.lastname: Askr
authors.forename: Youssef
authors.initials: Y
authors.lastname: Mahdy
authors.forename: Ahmed
authors.initials: A
authors.lastname: Elgawalby
authors.forename: Mohamed
authors.initials: M
authors.lastname: El Sorogy
authors.forename: Mostaffa
authors.initials: M
authors.lastname: Abu Zeied
authors.forename: Talaat
authors.initials: T
authors.lastname: Abdallah
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abd Elwahab
mesh_terms: D000368:Aged; D004534:Egypt / Q000453:epidemiology; D005260:Female; D018589:Gastroparesis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D012307:Risk Factors