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Analysis of Risk Factors for Delayed Gastric Emptying (DGE) after 387 Pancreaticoduodenectomies with Usage of 70 Stapled Reconstructions

  • Original Article
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Journal of Gastrointestinal Surgery

Abstract

Background

Delayed gastric emptying (DGE) is one of the most troublesome complications after pancreaticoduodenectomy (PD).

Methods

Between 2004 and 2009, 387 patients underwent PD and of these, 302 patients (78%) underwent pylorus-preserving PD. The stapled reconstruction of duodeno- or gastrojejunostomy was introduced in 2006, and 70 patients (18%) underwent stapled Roux-en-Y reconstruction. Postoperative DGE was defined based on the International Study Group on Pancreatic Surgery classification, and grade B or C DGE was considered to be clinically relevant. Risk factors for DGE were evaluated using univariate and multivariate analyses.

Results

Four patients died in the hospital (1.0%). Postoperative DGE was found in 70 patients (18%). DGE was less frequently seen in stapled reconstruction than in hand-sewn reconstruction (7.2% vs. 21%, P < 0.001), and in single-layer anastomosis than in double-layer anastomosis (12% vs. 24%, P = 0.02). The multivariate logistic regression analysis revealed that the independent risk factors for DGE were postoperative pancreatic fistula (risk ratio [RR] 2.4, P = 0.002), hand-sewn reconstruction (RR 2.9, P = 0.03) and male (RR 2.2, P = 0.02).

Conclusion

The method of alimentary reconstruction affected the occurrence of DGE. The incidence of DGE was less in stapled reconstruction than in hand-sewn reconstruction.

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Authors and Affiliations

  1. Hepatobiliary and Pancreatic Surgery Division, National Cancer Center Hospital, 5-1-1Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Yoshihiro Sakamoto, Yusuke Yamamoto, Shojiro Hata, Satoshi Nara, Minoru Esaki, Kazuaki Shimada & Tomoo Kosuge

  2. Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan

    Tsuyoshi Sano

Authors
  1. Yoshihiro Sakamoto
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  2. Yusuke Yamamoto
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  3. Shojiro Hata
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  4. Satoshi Nara
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  5. Minoru Esaki
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  6. Tsuyoshi Sano
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  7. Kazuaki Shimada
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  8. Tomoo Kosuge
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Correspondence to Yoshihiro Sakamoto.

Additional information

This work is supported in part by Grant-in-Aid for scientific research from the Ministry of Health and Welfare of Japan.

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Sakamoto, Y., Yamamoto, Y., Hata, S. et al. Analysis of Risk Factors for Delayed Gastric Emptying (DGE) after 387 Pancreaticoduodenectomies with Usage of 70 Stapled Reconstructions. J Gastrointest Surg 15, 1789–1797 (2011). https://doi.org/10.1007/s11605-011-1498-6

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  • DOI: https://doi.org/10.1007/s11605-011-1498-6

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