Delayed gastric emptying following pancreatic resection: Incidence, risk factors, and impact on healthcare utilization
Background: Delayed gastric emptying (DGE) frequently occurs following pancreaticoduodenectomy (PD). This study characterizes incidence and risk factors for DGE and examines its implications on healthcare utilization. ^ Methods: A prospectively-maintained database was reviewed. DGE was classified using International Study Group of Pancreatic Surgery criteria. Patients who developed DGE and those who did not were compared. ^ Results: 276 patients underwent PD (>80% pylorus-preserving, antecolic-reconstruction). DGE developed in 49 patients (17.8%): 5.1% grade B, 3.6% grade C. Demographic, clinical, and operative variables were similar between patients with DGE and those without. DGE patients were more likely to present multiple complications (32.6% versus 4.4%, ≥3 complications, P<0.001), including postoperative pancreatic fistula (POPF) (42.9% versus 18.9%, P=0.001) and intra-abdominal abscess (16.3% versus 4.0%, P=0.012). Patients with DGE had longer hospital stay (median, 12 versus 7 days, P<0.001) and were more likely to require transitional care upon discharge (24.5% versus 6.6%, P<0.001). On multivariate analysis, POPF was the only predictor for DGE (OR 3.29, P=0.021). ^ Conclusions: Although DGE occurred in <20% of patients after PD, it was associated with increased healthcare utilization. Patients with POPF were at risk for DGE. Anticipating DGE can help individualize care and allocate resources to high-risk patients.^
Mohammed, Somala, "Delayed gastric emptying following pancreatic resection: Incidence, risk factors, and impact on healthcare utilization" (2016). Texas Medical Center Dissertations (via ProQuest). AAI10127435.