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Risk factors for delayed gastric emptying following distal pancreatectomy

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Abstract

Purpose

Delayed gastric emptying (DGE) is a frequent complication after pancreatoduodenectomy and other types of upper gastrointestinal surgery with published incidences as high as 60 %. The present study examines the incidence of DGE following distal pancreatic resection (DPR).

Methods

Between 2002 and 2014, 100 patients underwent conventional DPR at our department. DGE was classified according to the 2007 International Study Group of Pancreatic Surgery definition. Patients were analyzed regarding severity of DGE, morbidity and mortality, length of hospital stay, and demographic factors.

Results

Overall incidence of DGE was 24 %. No difference in age, gender, or other demographic factors was observed in patients with DGE. Perioperative characteristics (splenectomy rate, closure technique of the pancreatic remnant, operation time, blood loss and transfusion, ICU, ASA score) were comparable. Major complications were associated with DGE (11/24 patients (46 %) vs. 19/76 patients (25 %) without DGE) and the rate of pancreatic fistula was significantly higher in the group of patients with DGE (14/24 patients (58 %) vs. 27/76 patients (36 %), P = 0.047). In multivariate analysis, a periampullary malignancy was shown to be a significant factor for DGE development. DGE significantly prolonged hospital stay (14 vs. 22 days).

Conclusions

DGE is a substantial complication not only after pancreatoduodenectomy, but it also occurs frequently after DPR. Prevention of pancreatic fistula might reduce its incidence, especially in patients with malign pathology.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Bonn, Sigmund-Freud-Strasse 25, Bonn, 53105, Germany

    Tim R. Glowka, Martin von Websky, Dimitrios Pantelis, Steffen Manekeller, Jörg C. Kalff & Nico Schäfer

  2. Department of Surgery, Krankenhaus Maria Stern, Am Anger 1, Remagen, 53424, Germany

    Jens Standop

Authors
  1. Tim R. Glowka
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  2. Martin von Websky
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  3. Dimitrios Pantelis
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  7. Nico Schäfer
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Corresponding author

Correspondence to Tim R. Glowka.

Ethics declarations

All procedures performed in the study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Author's contributions

Study conception and design: Tim R. Glowka, Jens Standop, Nico Schäfer. Acquisition of data: Tim R. Glowka, Dimitrios Pantelis, Steffen Manekeller, Nico Schäfer. Analysis and interpretation of data: Tim R. Glowka, Martin von Websky, Dimitrios Pantelis, Steffen Manekeller, Nico Schäfer. Drafting of manuscript: Tim R. Glowka and Nico Schäfer. Critical revision of manuscript: Tim R. Glowka, Martin von Websky, Dimitrios Pantelis, Steffen Manekeller, Jens Standop, Jörg C. Kalff, Nico Schäfer.

Conflict of interest

The authors declare that they have no competing interests.

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Glowka, T.R., von Websky, M., Pantelis, D. et al. Risk factors for delayed gastric emptying following distal pancreatectomy. Langenbecks Arch Surg 401, 161–167 (2016). https://doi.org/10.1007/s00423-016-1374-7

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  • DOI: https://doi.org/10.1007/s00423-016-1374-7

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