Peri-operative risk factors for delayed gastric emptying after a pancreaticoduodenectomy

HPB : the Official Journal of the International Hepato Pancreato Biliary Association
Jamie R RobinsonAlexander A Parikh

Abstract

Delayed gastric emptying (DGE) is a frequent cause of morbidity, prolonged hospital stay and readmission after a pancreaticoduodenectomy (PD). We sought to evaluate predictive peri-operative factors for DGE after a PD. Four hundred and sixteen consecutive patients who underwent a PD at our tertiary referral centre were identified. Univariate and multivariate (MV) logistic regression models were used to assess peri-operative factors associated with the development of clinically significant DGE and a post-operative pancreatic fistula (POPF). DGE occurred in 24% of patients (n = 98) with Grades B and C occurring at 13.5% (n = 55) and 10.5% (n = 43), respectively. Using MV regression, a body mass index (BMI) ≥35 [odds ratio (OR) = 3.19], operating room (OR) length >5.5 h (OR = 2.72) and prophylactic octreotide use (OR = 2.04) were independently associated with an increased risk of DGE. DGE patients had a significantly longer median hospital stay (12 versus 7 days), higher 90-day readmission rates (32% versus 18%) and an increased incidence of a pancreatic fistula (59% versus 27%). When controlling for POPF, only OR length >5.5 h (OR 2.73) remained significantly associated with DGE. DGE remains a significant cause of morbidity, incr...Continue Reading

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Mar 26, 2016·Surgical Oncology Clinics of North America·Beth A HelminkAlexander A Parikh
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Jul 3, 2021·Journal of Clinical Medicine·Jana EnderesTim R Glowka
Apr 15, 2020·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Nobuyuki WatanabeMasato Nagino

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