Risk Factor Identification for Delayed Gastric Emptying after Distal Pancreatectomy—An Evaluation of 1688 Patients Based on the German StuDoQ|Pancreas Registry

Abstract

Delayed gastric emptying (DGE) ranks as one of the most frequent complications in pancreatic surgery. It leads to increased costs for healthcare systems, lengthened hospital stays and reduced quality of life. Data about DGE after distal pancreatectomy (DP) are scarce. The StuDoQ|Pancreas registry of the German Society of General and Visceral Surgery provided data of patients who underwent distal pancreatectomy from 1 January 2014 to 31 December 2018. The retrospective evaluation included comprehensive data: 1688 patients were enrolled; DGE occurred 160 times (9.5%); grade “A” was reported for 98 (61.3%), grade “B” for 41 (25.6%) and grade “C” for 21 (13.1%) patients. In univariate analysis pancreatic fistulas were associated with higher frequencies of intraabdominal abscesses (9.1% vs. 2%, p > 0.001), postpancreatectomy haemorrhage (8.1% vs. 3.7%, >0.001) and DGE (14.5% vs. 6%, p < 0.001). According to multivariate analysis, “abscesses with invasive therapy” (p < 0.001), “other surgical complications” (p < 0.001), prolonged “stays in ICU” (p < 0.001), lengthened duration of surgery (p < 0.001) and conventional surgery (p = 0.007) were identified as independent risk factors for DGE. Perioperative and postoperative factors were identified as risk factors for DGE. Following research should examine this highly relevant topic in a prospective, register-based manner. As there is no causal therapy for DGE, its avoidance is of major importance.

Impact of preoperative chemotherapy on surgical results in 139 patients with locally advanced pancreatic cancer

“…Another cause for severe morbidity and high mortality rates is PPH, caused by an erosion of vessels by pancreatic fluids ( 33 ). We reported similar rates of PPH in comparison to data in the literature ( 32 ). In conclusion, surgery after PCT was not associated with increased postoperative morbidity.…”

“…It was found in 26.3% after PD and in 12.5% after DP. This corresponds to the results of analyses of German registry data ( 22 , 32 ). Another cause for severe morbidity and high mortality rates is PPH, caused by an erosion of vessels by pancreatic fluids ( 33 ).…”