AI Article Synopsis
- The study aimed to identify the incidence and risk factors of delayed gastric emptying (DGE) after pancreaticoduodenectomy while assessing its impact on healthcare use.
- In a review of 276 patients, DGE occurred in 49 (17.8%), with significant complications such as postoperative pancreatic fistula (POPF) and intra-abdominal abscess (IAA) being more prevalent in DGE patients.
- Patients with DGE had longer hospital stays and were more likely to require transitional care, and predictors for DGE included the presence of POPF and IAA.
Article Abstract
Aim: To characterize incidence and risk factors for delayed gastric emptying (DGE) following pancreaticoduodenectomy and examine its implications on healthcare utilization.
Methods: A prospectively-maintained database was reviewed. DGE was classified using International Study Group of Pancreatic Surgery criteria. Patients who developed DGE and those who did not were compared.
Results: Two hundred and seventy-six patients underwent pancreaticoduodenectomy (PD) (> 80% pylorus-preserving, antecolic-reconstruction). DGE developed in 49 patients (17.8%): 5.1% grade B, 3.6% grade C. Demographic, clinical, and operative variables were similar between patients with DGE and those without. DGE patients were more likely to present multiple complications (32.6% 4.4%, ≥ 3 complications, < 0.001), including postoperative pancreatic fistula (POPF) (42.9% 18.9%, = 0.001) and intra-abdominal abscess (IAA) (16.3% 4.0%, = 0.012). Patients with DGE had longer hospital stay (median, 12 d 7 d, < 0.001) and were more likely to require transitional care upon discharge (24.5% 6.6%, < 0.001). On multivariate analysis, predictors for DGE included POPF [OR = 3.39 (1.35-8.52), = 0.009] and IAA [OR = 1.51 (1.03-2.22), = 0.035].
Conclusion: Although DGE occurred in < 20% of patients after PD, it was associated with increased healthcare utilization. Patients with POPF and IAA were at risk for DGE. Anticipating DGE can help individualize care and allocate resources to high-risk patients.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5366929 | PMC |
| http://dx.doi.org/10.4240/wjgs.v9.i3.73 | DOI Listing |
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