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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Preoperative and postoperative complications as risk factors for delayed gastric emptying following pancreaticoduodenectomy: A single-center retrospective study
Fang-Liang Xie, Li-Jun Ren, Wei-Dong Xu, Tong-Lei Xu, Xia-Qing Ge, Wei Li, Xu-Ming Ge, Wen-Kai Zhou, Kai Li, Yun-Hai Zhang, Zhong Wang
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
ARTICLE HIGHLIGHTS
Research background
Mortality after pancreaticoduodenectomy (PD) has decreased to very low levels in specialized centers. However, postoperative morbidity remains high. Delayed gastric emptying (DGE) still remains the most frequent complication following pancreatoduodenectomy (PD).
Research motivation
When it comes to treatment, the specific pathogenesis of DGE remains uncharacterized, nor is there a specific treatment plan for DGE, resulting in unsatisfactory effects of various treatment approaches. The purpose of this study is to thoroughly explore the risk factors of the disease and introduce a new treatment method.
Research objectives
This study aims to identify related risk factors for DGE after the PD procedure.
Research methods
In this retrospective, cross-sectional study, clinical data were collected from 114 patients who underwent PD from January 2015 to June 2018. They were analyzed regarding demographic factors, pre- and perioperative characteristics, and surgical complications. Univariate and multivariate analyses were performed to identify the risk factors for post-PD DGE.
Research 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 (PPPD). 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.
Research conclusions
Postoperative severe abdominal complications, preoperative systemic disease and early postoperative ALB are risk factors for post-PD DGE.
Research perspectives
The research perspective of this study is to thoroughly explore the risk factors for post-PD DGE.
