Journal of Gastrointestinal Surgery

, Volume 19, Issue 9, pp 1572–1580 | Cite as

Delayed Gastric Emptying After Pancreaticoduodenectomy: an Analysis of Risk Factors and Cost

  • Joshua D. Eisenberg
  • Ernest L. Rosato
  • Harish Lavu
  • Charles J. Yeo
  • Jordan M. WinterEmail author
2015 SSAT Poster Presentation



Delayed gastric emptying (DGE) is a common complication after pancreaticoduodenectomy (PD), yet it remains incompletely understood. The International Study Group of Pancreatic Surgery (ISGPS) in 2007 defined a three-tiered grading system to standardize studies of DGE.


In this study, 721 patients undergoing PD between 2006 and 2012 were retrospectively categorized by the ISGPS DGE criteria, as well as a modified grading system (termed primary DGE) if, on retrospective review, DGE was not believed to be a sequela of a separate complication. Predictive factors and associated outcomes were determined.


ISGPS-defined DGE occurred in 140 (19.4 %) patients. In a multivariate analysis, predictors of ISGPS-defined DGE included abdominal infection (odds ratio (OR) 5.5, p < 0.001), male gender (OR 1.92, p = 0.007), smoking history (OR 1.75 p = 0.033), and periampullary adenocarcinoma (OR 1.66, p = 0.041). Primary DGE occurred in 12.2 % of patients. Predictors included abdominal infection (OR 3.15, p < 0.001) and smoking history (OR 2.04, p = 0.008). Median hospital charges increased over $10,000 with each severity grade of DGE (p < 0.001).


DGE is common after PD and contributes substantially to cost. DGE is frequently a secondary complication of abdominal infection, and interventions that limit such complications may be the most effective strategy toward preventing DGE.


Pancreaticoduodenectomy Post-operative complications Gastric emptying Gastroparesis 


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Copyright information

© The Society for Surgery of the Alimentary Tract 2015

Authors and Affiliations

  • Joshua D. Eisenberg
    • 1
  • Ernest L. Rosato
    • 1
  • Harish Lavu
    • 1
  • Charles J. Yeo
    • 1
  • Jordan M. Winter
    • 1
    • 2
    Email author
  1. 1.Department of Surgery, The Jefferson Pancreas, Biliary, and Related Cancer CenterThomas Jefferson UniversityPhiladelphiaUSA
  2. 2.PhiladelphiaUSA

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