WHAT FACTORS CONTRIBUTE TO DELAYED GASTRIC EMPTYING AFTER DUODENOPANCREATECTOMY WITH PILORIC PRESERVATION?

Area of Science:

• Gastroenterology
• Surgical Oncology
• Abdominal Surgery

Background:

• Delayed gastric emptying (DGE) is a frequent complication following duodenopancreatectomy with pyloric preservation.
• DGE significantly increases hospitalization duration and associated healthcare costs.
• Identifying predictors of DGE is crucial for improving patient outcomes.

Purpose of the Study:

• To determine the factors contributing to delayed gastric emptying after pylorus-preserving duodenopancreatectomy.
• To analyze predictors of DGE in patients undergoing this specific surgical procedure.

Main Methods:

• Retrospective analysis of medical records from 95 patients who underwent duodenopancreatectomy with pyloric preservation.
• Application of univariate and multivariate logistic regression to identify predictors of delayed gastric emptying.
• Assessment of complications, including pancreatic fistula, abdominal collections, hypoalbuminemia, and bilirubin levels.

Main Results:

• Delayed gastric emptying occurred in 65% of patients.
• Pancreatic complications (e.g., pancreatic fistula), intracavitary complications with abdominal collections, and hypoalbuminemia were significant predictors of DGE.
• Elevated total and direct bilirubin levels were associated with DGE in cases without a clear cause.

Conclusions:

• Intracavitary complications are the primary cause of delayed gastric emptying in patients undergoing duodenopancreatectomy with pyloric preservation.
• Early identification and management of pancreatic and other intracavitary complications may help mitigate DGE.
• Further research into the role of bilirubin levels in DGE is warranted.