Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Sep 27, 2023; 15(9): 1941-1949
Published online Sep 27, 2023. doi: 10.4240/wjgs.v15.i9.1941
Preoperative and postoperative complications as risk factors for delayed gastric emptying following pancreaticoduodenectomy: A single-center retrospective study
Zhong Wang, Yun-Hai Zhang, Kai Li, Wen-Kai Zhou, Xu-Ming Ge, Wei Li, Xia-Qing Ge, Tong-Lei Xu, Wei-Dong Xu, Li-Jun Ren, Fang-Liang Xie
Fang-Liang Xie, Wei-Dong Xu, Tong-Lei Xu, Xia-Qing Ge, Wei Li, Xu-Ming Ge, Wen-Kai Zhou, Kai Li, Zhong Wang, Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
Li-Jun Ren, Operating Theatre, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
Yun-Hai Zhang, Department of Pain, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), Lianyungang 222061, Jiangsu Province, China
Author contributions: Xie FL and Ren LJ contributed equally to this work and are co-first authors; Xie FL and Ren LJ designed the research and wrote the first manuscript; Wang Z, Xu WD, Xu TL, Ge XQ, LW, Ge XM and Zhou WK contributed to conceiving the research and analyzing data; Wang Z, Li K and Zhang YH conducted the analysis and provided guidance for the research; all authors reviewed and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang) (Approval No. LW-20230411001-01).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: There is no conflict of interest.
Data sharing statement: All data and materials are available from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhong Wang, Doctor, Doctor, Department of Hepatobiliary Surgery, Xuzhou Medical University Affiliated Hospital of Lianyungang (The First People's Hospital of Lianyungang), No. 6 Zhenhua East Road, Haizhou District, Lianyungang 222061, Jiangsu Province, China. wanglyggdwk@126.com
Received: May 19, 2023
Peer-review started: May 19, 2023
First decision: June 1, 2023
Revised: June 21, 2023
Accepted: July 18, 2023
Article in press: July 18, 2023
Published online: September 27, 2023
Processing time: 126 Days and 3.6 Hours
Abstract
BACKGROUND

Mortality rates after pancreaticoduodenectomy (PD) have significantly decreased in specialized centers. However, postoperative morbidity, particularly delayed gastric emptying (DGE), remains the most frequent complication following PD.

AIM

To identify risk factors associated with DGE after the PD procedure.

METHODS

In this retrospective, cross-sectional study, clinical data were collected from 114 patients who underwent PD between January 2015 and June 2018. Demographic factors, pre- and perioperative characteristics, and surgical complications were assessed. Univariate and multivariate analyses were performed to identify risk factors for post-PD DGE.

RESULTS

The study included 66 males (57.9%) and 48 females (42.1%), aged 33-83 years (mean: 62.5), with a male-to-female ratio of approximately 1.4:1. There were 63 cases (55.3%) of PD and 51 cases (44.7%) of pylorus-preserving pancreatoduodenectomy. Among the 114 patients who underwent PD, 33 (28.9%) developed postoperative DGE. Univariate analysis revealed significant differences in four of the 14 clinical indexes observed: pylorus preservation, retrocolonic anastomosis, postoperative abdominal complications, and early postoperative albumin (ALB). Logistic regression analysis further identified postoperative abdominal complications [odds ratio (OR) = 4.768, P = 0.002], preoperative systemic diseases (OR = 2.516, P = 0.049), and early postoperative ALB (OR = 1.195, P = 0.003) as significant risk factors.

CONCLUSION

Postoperative severe abdominal complications, preoperative systemic diseases, and early postoperative ALB are identified as risk factors for post-PD DGE.

Keywords: Delayed gastric emptying; Postoperation; Pancreaticoduodenectomy; Treatment

Core Tip: This study enrolled 114 patients with pancreaticoduodenectomy (PD) over a recent 5-year period at a single center with a short time span and detailed and reliable data. To investigate the risk factors for delayed gastric emptying after PD. We have draw the conclusion that postoperative severe abdominal complications, preoperative systemic diseases and early postoperative albumin are risk factors for post-PD delayed gastric emptying.