Delayed gastric emptying after pancreatoduodenectomy: an analysis of risk factors

Updates Surg. 2024 Aug;76(4):1247-1255. doi: 10.1007/s13304-024-01795-6. Epub 2024 Apr 10.

Abstract

Background: Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy. Preoperative factors are limited and controversial. This study aims to identify associated factors related to this complication in the Colombian population.

Methods: A retrospective review of a prospectively collected database was conducted. All patients over 18 years of age who underwent pancreaticoduodenectomy were included. Associations with DGE syndrome were evaluated with logistic regression analysis, Odds ratio, and b-coefficient were provided when appropriate.

Results: 205 patients were included. Male patients constituted 54.15% (n = 111). 53 patients (25.85%) were diagnosed with DGE syndrome. Smoking habit (OR 17.58 p 0.00 95% CI 7.62-40.51), hydromorphone use > 0.6 mg/daily (OR 11.04 p 0.03 95% CI 1.26-96.66), bilirubin levels > 6 mg/dL (OR 2.51 p 0.02 95% CI 1.12-5.61), and pancreatic fistula type B (OR 2.72 p 0.02 CI 1.74-10.00).

Discussion: Smoking history, opioid use (hydromorphone > 0.6 mg/Daily), type B pancreatic fistula, and bilirubin levels > 6 mg/dL should be considered as risk factors for DGE.

Keywords: Delayed gastric emptying; Morbidity; Pancreatic fistula; Pancreatoduodenectomy.

MeSH terms

  • Adult
  • Aged
  • Analgesics, Opioid / administration & dosage
  • Bilirubin / blood
  • Female
  • Gastric Emptying* / physiology
  • Gastroparesis / epidemiology
  • Gastroparesis / etiology
  • Humans
  • Male
  • Middle Aged
  • Pancreatic Fistula / epidemiology
  • Pancreatic Fistula / etiology
  • Pancreaticoduodenectomy* / adverse effects
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Retrospective Studies
  • Risk Factors
  • Smoking / adverse effects

Substances

  • Bilirubin
  • Analgesics, Opioid