Delayed gastric emptying after pancreaticoduodenectomy

• Published in: The Journal of surgical research 2016-05, Vol.202 (2), p.380-388
• Main Authors: Hanna, Mena M., MD, Gadde, Rahul, MD, Allen, Casey J., MD, Meizoso, Jonathan P., MD, Sleeman, Danny, MD, FACS, Livingstone, Alan, MD, FACS, Merchant, Nipun, MD, Yakoub, Danny, MD, PhD
• Format: Article
• Language: English
• Subjects: Antecolic; Delayed gastric emptying; Gastrojejunostomy; Gastroparesis - etiology; Gastroparesis - prevention & control; Humans; Minimally invasive pancreaticoduodenectomy; Models, Statistical; Outcome Assessment (Health Care); Pancreaticoduodenectomy - methods; Pancreaticogasterostomy; Pancreaticojejunostomy; Postoperative Complications - etiology; Postoperative Complications - prevention & control; Pylorus preserving pancreaticoduodenectomy; Retrocolic; Roux-en-Y; Subtotal stomach preserving pancreaticoduodenectomy; Surgery
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2015.12.053

Abstract Background Delayed gastric emptying (DGE) remains an unsolved complication after pancreaticoduodenectomy (PD) with conflicting reports of its cause. We aimed to compare the effect of surgical techniques involving the stomach in PD in lowering the risk of postoperative DGE. Methods Online search and review of key bibliographies in PubMed, Medline, Embase, Scopus, Cochrane, and Google Scholar was performed. Studies comparing PD surgical techniques were identified. Primary outcome was postoperative DGE. Methodological quality was assessed using STROBE and CONSORT. Calculated pooled relative risk and odds ratios (ORs) with the corresponding 95% confidence interval (CI) were used in the meta-analyses. Results Overall, 376 studies were reviewed, of which 22 studies were selected including a total of 5172 patients. The incidence of DGE was lower in antecolic compared with retrocolic gastrojejunostomy (risk ratio [RR], 0.260; CI, 0.157–0.431; P