An analysis of the possible factors contributing to the delayed return of gastric emptying after gastrojejunostomy

Abstract

The possible factors contributing to delayed-return gastric emptying (DRGE) after gastrojejunostomy were analyzed through a review of 955 consecutive patients who had undergone gastric surgery for the first time, which revealed 23 patients who had experienced DRGE. Of 7 consecutive patients who had undergone a reoperation for postsurgical gastroparesis syndrome, 3 were found to have experienced persistent DRGE. The chi-squared and/or Student's t-tests showed the significant factors to be (a) an age over 60, and (b) a history or nonresection gastric bypass, Roux-en-Y reconstruction, or reoperation for the preexistence of postoperative gastroparesis, with P values of less than 0.05. There was a higher incidence of DRGE in patients who had received a vagotomy, and there were increasing nutritional indices when patients were recovered from DRGE; however, vagotomy and malnutrition could not be considered independent variables. In conclusion, the incidence of DRGE was significant in patients aged over 60 who had undergone gastrojejunostomy, with nongastric resection, Roux-en-Y reconstruction, or reoperation for gastroparesis. In the event of DRGE, a longer period of supportive treatment is required to avoid unnecessary second surgery as most patients recover spontaneously, whereas a high incidence of persistent DRGE may occur following early reoperation.