The Clinical Analysis And Research Of Gastroparesis After Pancreaticoduodenectomy

Objective: To analyse risk factors and summarize preventive and treatmentmethods of gastroparesis after pancreaticoduodenectomy by statistical analyselarge sample cases of patients after pancreaticoduodenectomy in our single centerand review worldwide literatures,and provide suggestive preventive and treatmentmethods for gastroparesis patients.Methods: We retrospectively analyzed the clinical data of580patients afterpancreaticoduodenectomy between January2008and December2012.Data of580patients after pancreaticoduodenectomy were compared, which included: generalinformation(gender, age, et al); operation information(intraoperative blood loss,operation method, et al); post-operation information(complication, the placementof jejunum nutrition tube, the time of gastrointestinal decompression,et al).Referto related literature about gastroparesis after pancreaticoduodenectomyat homeand abroad.Results: The580cases who underwent pancreaticoduodenectomy included20cases underwent portal-vein or superior mesenteric vein resection andconstruction and5cases underwent conbined other visceras resetion,78casessuffered postoperative delayed gastric emptying,the incidence was13.4%.77caseswere cured by conservertive treatment,1case was cured by operation afterconservative treatment of178days but invalid.The occurrence time ofgastroparesis was5to32days after operation,the median time was12days; theaverage time was11.1±4.7days.There were significantly statistical difference inage, operation method,preoperative biliary drainage treatment and postoperativebiliary fistula between two groups(P﹤0.05).And there were no significantdifference of gender, intraoperative blood loss, the time of gastrointestinaldecompression,pathology and poatoperative pancreatic fistula and bleeding between two groups(P﹥0.05). The gastroparesis cases were higher inpostoperative hospital stay time than cases who did not occure gastroparesis.Therewas no gastroparesis patient dead.Conclusions:(1)The gastroparesis after pancreaticoduodenectomy is a functionaldiserse and it can significantly extend postoperative hospital stay time,so theconservertive treatment should be considered firstly, and the reoperativeindications and timeshould be selected very strictly.(2) Patients’age,postoperative biliary fistula are independent risk factors of gastroparesis patientsafter pancreaticoduodenectomy.(3) The incidence of gastroparesis is higher inPPPD group than PD group.(4) There may be relationship between gastroparesisand hyperbilirubinemia.(5) Gender, intraoperative blood loss,the time ofpostoperative gastrointestinal decompression,pancreatic fistula, postoperativebleeding,jejunum nutrition and pathology type have no relationship withpostoperative gastroparesis.