Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr;75(3):523-530.
doi: 10.1007/s13304-022-01404-4. Epub 2022 Oct 30.

Delayed gastric emptying is associated with increased risk of mortality in patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma

Oscar Hernandez Dominguez  1 , Areg Grigorian  1 , Ronald F Wolf  1 , David K Imagawa  1 , Jeffry T Nahmias  1 , Zeljka Jutric  2
Affiliations

Delayed gastric emptying is associated with increased risk of mortality in patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma

Oscar Hernandez Dominguez et al. Updates Surg. 2023 Apr.

Abstract

Delayed gastric emptying (DGE) is common in patients undergoing pancreaticoduodenectomy (PD). The effect of DGE on mortality is less clear. We sought to identify predictors of mortality in patients undergoing PD for pancreatic adenocarcinoma hypothesizing DGE to independently increase risk of 30-day mortality. The ACS-NSQIP targeted pancreatectomy database (2014-2017) was queried for patients with pancreatic adenocarcinoma undergoing PD. A multivariable logistic regression analysis was performed. Separate sensitivity analyses were performed adjusting for postoperative pancreatic fistula (POPF) grades A-C. Out of 8011 patients undergoing PD, 1246 had DGE (15.6%). About 8.5% of patients with DGE had no oral intake by postoperative day-14. The DGE group had a longer median operative duration (373 vs. 362 min, p = 0.019), and a longer hospital length of stay (16.5 vs. 8 days, p < 0.001). After adjusting for age, gender, comorbidities, preoperative chemotherapy, preoperative radiation, open versus laparoscopic approach, vascular resection, deep surgical space infection (DSSI), postoperative percutaneous drain placement, and development of a POPF, DGE was associated with an increased risk for 30-day mortality (OR 3.25, 2.16-4.88, p < 0.001). On sub-analysis, grades A and B POPF were not associated with risk of mortality while grade C POPF was associated with increased risk of mortality (OR 5.64, 2.24-14.17, p < 0.001). The rate of DGE in patients undergoing PD in this large database was over 15%. DGE is associated with greater than three times the increased associated risk of mortality, even when controlling for POPF, DSSI, and other known predictors of mortality.

Keywords: Delayed gastric emptying; Pancreatic cancer; Pancreatic fistula; Pancreaticoduodenectomy.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.

References

    1. National Cancer Institute. SEER Cancer Stat Facts. National Institutes of Health. https://seer.cancer.gov/statfacts/html/pancreas.html. Published 2022. Accessed July 14, 2022.
    1. Torphy RJ, Fujiwara Y, Schulick RD. Pancreatic cancer treatment: better, but a long way to go. Surg Today. 2020;50(10):1117. doi: 10.1007/S00595-020-02028-0. - DOI - PMC - PubMed
    1. Narayanan S, Martin AN, Turrentine FE, Bauer TW, Adams RB, Zaydfudim VM. Mortality after pancreaticoduodenectomy: assessing early and late causes of patient death. J Surg Res. 2018;231:304–308. doi: 10.1016/J.JSS.2018.05.075. - DOI - PMC - PubMed
    1. Panni RZ, Panni UY, Liu J, et al. Re-defining a high volume center for pancreaticoduodenectomy. HPB. 2021;23(5):733–738. doi: 10.1016/j.hpb.2020.09.009. - DOI - PubMed
    1. Complications SR, Pancreaticoduodenectomy A. Complications after pancreaticoduodenectomy. Surg Clin North Am. 2021;101(5):865–874. doi: 10.1016/j.suc.2021.06.011. - DOI - PubMed

MeSH terms