title: Primary versus secondary delayed gastric emptying (DGE) grades B and C of the International Study Group of Pancreatic Surgery after pancreatoduodenectomy: a retrospective analysis on a group of 132 patients.
abstract: Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy (PDD) significantly contributing to post-operative morbidity. Clinical risk factors for DGE occurrence after PDD remain controversial. From January 2004 to December 2011, a total of 132 patients underwent PDD for either malignancies (73.5%) or benign diseases (26.5%) in one single universitary center. Post-operative mortality and morbidity were, respectively, 3 and 44.7%. DGE has been defined in accordance with the International Study Group of Pancreatic Surgery (ISGPS) classification. DGE was distinguished in primary or secondary. Factors associated with grades B and C of DGE, based on severity and clinical impact, were assessed by means of univariate and multivariate analysis. Thirty-eight patients (28.8%) had clinical DGE grade B or C. Post-operative complications (pancreatic fistula and/or hemorrhage or anastomotic leak) were reported in 25 out of the 38 patients (65.8%, secondary DGE), while in 13 patients it was not associated to any other complication (34.2%, primary DGE). Post-operative complications (pancreatic fistula and hemorrhage) appeared to be the most important predictive factor for Grade B or C DGE.
authors.affiliation: Service de Chirurgie, CHU Poitiers, 2 rue de la Miletrie, BP 577, 86021, Poitiers Cedex, France.
authors.forename: T
authors.initials: T
authors.lastname: Courvoisier
authors.forename: Gianluca
authors.initials: G
authors.lastname: Donatini
authors.forename: J P
authors.initials: JP
authors.lastname: Faure
authors.forename: J
authors.initials: J
authors.lastname: Danion
authors.forename: M
authors.initials: M
authors.lastname: Carretier
authors.forename: J P
authors.initials: JP
authors.lastname: Richer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057868:Anastomotic Leak / Q000503:physiopathology; D001649:Bile Duct Diseases / Q000601:surgery; D016063:Blood Loss, Surgical / Q000503:physiopathology; D004378:Duodenal Diseases / Q000601:surgery; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010182:Pancreatic Diseases / Q000601:surgery; D010185:Pancreatic Fistula / Q000503:physiopathology; D016577:Pancreaticoduodenectomy / Q000009:adverse effects*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult