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Predictive Factors for Delayed Gastric Emptying After Pancreatoduodenectomy : A Swedish National Registry-Based Study

Zdanowski, A. Hörberg ; Wennerblom, J. ; Rystedt, J. LU ; Andersson, B. ; Tingstedt, B. LU and Williamsson, Caroline LU (2023) In World Journal of Surgery 47(12). p.3289-3297
Abstract

Background: Delayed gastric emptying (DGE) is a common complication after pancreatoduodenectomy (PD). DGE causes prolonged hospital stay and a decrease in quality of life. This study analyzes predictive factors for development of DGE after PD, also in the absence of surgical complications. Method: Data from the Swedish National Pancreatic Cancer Registry for patients undergoing standard and pylorus preserving open PD from January 2010 until June 30, 2018, were collected. Data were analyzed in two groups, no DGE and DGE. A subgroup of patients with DGE but without surgical complications was compared to patients without DGE or any other surgical complication. Results: In total, 2503 patients were included, of which 470 (19%) had DGE. In... (More)

Background: Delayed gastric emptying (DGE) is a common complication after pancreatoduodenectomy (PD). DGE causes prolonged hospital stay and a decrease in quality of life. This study analyzes predictive factors for development of DGE after PD, also in the absence of surgical complications. Method: Data from the Swedish National Pancreatic Cancer Registry for patients undergoing standard and pylorus preserving open PD from January 2010 until June 30, 2018, were collected. Data were analyzed in two groups, no DGE and DGE. A subgroup of patients with DGE but without surgical complications was compared to patients without DGE or any other surgical complication. Results: In total, 2503 patients were included, of which 470 (19%) had DGE. In the DGE group, 238 had other coexisting surgical complications and 232 had not. Postoperative pancreatic fistula (OR = 4.22, p < 0.001), surgical infection (OR = 1.44, p = 0.013), heart disease (OR = 1.32, p = 0.023) and medical complications (OR = 1.35, p = 0.025) increased the risk for DGE. A standard PD compared with pylorus preserving resection (OR = 1.69, p = 0.001) and a reconstruction with a pancreaticojejunostomy compared with a pancreaticogastrostomy (OR = 1.83, p < 0.001) increased the risk. For patients without surgical complications, a standard PD and reconstruction with pancreaticojejunostomy still increased the risk for DGE. Conclusion: DGE is more common after standard PD compared to pylorus preserving PD and after reconstruction with PJ compared to PG in this national cohort, both in the presence of other surgical complications as well as in the absence of other complications.

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type
Contribution to journal
publication status
published
subject
in
World Journal of Surgery
volume
47
issue
12
pages
9 pages
publisher
Springer
external identifiers
  • pmid:37702776
  • scopus:85171134341
ISSN
0364-2313
DOI
10.1007/s00268-023-07175-2
language
English
LU publication?
yes
id
6a272407-e523-46f8-bece-7350c5c223c5
date added to LUP
2023-12-28 09:57:37
date last changed
2024-04-26 16:55:26
@article{6a272407-e523-46f8-bece-7350c5c223c5,
  abstract     = {{<p>Background: Delayed gastric emptying (DGE) is a common complication after pancreatoduodenectomy (PD). DGE causes prolonged hospital stay and a decrease in quality of life. This study analyzes predictive factors for development of DGE after PD, also in the absence of surgical complications. Method: Data from the Swedish National Pancreatic Cancer Registry for patients undergoing standard and pylorus preserving open PD from January 2010 until June 30, 2018, were collected. Data were analyzed in two groups, no DGE and DGE. A subgroup of patients with DGE but without surgical complications was compared to patients without DGE or any other surgical complication. Results: In total, 2503 patients were included, of which 470 (19%) had DGE. In the DGE group, 238 had other coexisting surgical complications and 232 had not. Postoperative pancreatic fistula (OR = 4.22, p &lt; 0.001), surgical infection (OR = 1.44, p = 0.013), heart disease (OR = 1.32, p = 0.023) and medical complications (OR = 1.35, p = 0.025) increased the risk for DGE. A standard PD compared with pylorus preserving resection (OR = 1.69, p = 0.001) and a reconstruction with a pancreaticojejunostomy compared with a pancreaticogastrostomy (OR = 1.83, p &lt; 0.001) increased the risk. For patients without surgical complications, a standard PD and reconstruction with pancreaticojejunostomy still increased the risk for DGE. Conclusion: DGE is more common after standard PD compared to pylorus preserving PD and after reconstruction with PJ compared to PG in this national cohort, both in the presence of other surgical complications as well as in the absence of other complications.</p>}},
  author       = {{Zdanowski, A. Hörberg and Wennerblom, J. and Rystedt, J. and Andersson, B. and Tingstedt, B. and Williamsson, Caroline}},
  issn         = {{0364-2313}},
  language     = {{eng}},
  number       = {{12}},
  pages        = {{3289--3297}},
  publisher    = {{Springer}},
  series       = {{World Journal of Surgery}},
  title        = {{Predictive Factors for Delayed Gastric Emptying After Pancreatoduodenectomy : A Swedish National Registry-Based Study}},
  url          = {{http://dx.doi.org/10.1007/s00268-023-07175-2}},
  doi          = {{10.1007/s00268-023-07175-2}},
  volume       = {{47}},
  year         = {{2023}},
}