Risk Factors Influencing Delayed Gastric Emptying After Pancreaticoduodenectomy

Objectives To Study effects of pancreaticoduodenectomy resection after gastricemptying disorder associated risk factors, to explore the Preventive measures, of gastricemptying disorder in order to reduce the incidence of gastric emptying disorder afterresection of Pancreas duodenum.Methods Delayed gastric emptying is defined as: the exclusion of obstruction, underthe Premise of anastigmatic and other mechanical factors, one of two situations:(1)postoperative indwelling nose-gastric More than14d, or (2) Disconnect the stomachafter the tube can not eat solid food after surgery due to abdominal distension, nausea,vomiting and other reasons need to Put into the tube again. A case-control study, selectedfrom January of2011to December of2013，Kailuan Hospital Hepatobiliary SurgeryDepartment operated122pancreatic duodenal routine clinical data were retrospectivelyanalyzed. By the definition of delayed gastric emptying of gastric emptying Patients weredivided into groups and non-delayed gastric emptying group, count data applications Chi-squared test, Fisher’s exact inspection, measurement data applications student’s-t test andother statistical methods to analyze the two groups complications, operative time, intra-operative blood transfusion before the age, sex, surgery, the difference preoperative andpostoperative laboratory findings, postoperative complications and to identify risk factors,combined with the literature mentioned in the relevant factors into Logistic Regressionanalysis to determine the risk factors for Pancreatic resection of gastric emptying.Results122cases of pancreaticoduodenectomy14cases of postoperative Patientswith delayed gastric emptying occurs, the rate was11.5%. Delayed gastric emptying inPatients with non-group and group of delayed gastric emptying in gender, age,preoperative comparability (hypertension and diabetes), preoperative hemoglobin, totalProtein, albumin, alanine aminotransferase, total bilirubin and other non-statistical Learnthe difference (P>0.05). In the operative time, blood loss, whether T-tube and so nosignificant difference (P>0.05). In the postoperative Pathological type, no significantdifference (P>0.05) hemoglobin, total protein, albumin levels. Logistic regression results:elderly Patients (P <0.05), preoperative albumin levels (P <0.05), preoperative totalbilirubin level (P <0.05), Preoperative fasting glucose levels (P <0.05), blood loss (P <0.05), Postoperative complications (P <0.01) were risk factors for Postoperative DGE inPD.Multivariate Logistic regression analysis: Preoperative albumin level was higher afterPancreaticoduodenectomy Prevention of delayed gastric emptying Protective factor (OR<1, P=0.001) occurred; whereas Preoperative fasting blood glucose higher levels (OR>1,P <0.001) and the other Postoperative complications (OR>1, P=0.001) were risk factorsfor delayed gastric emptying after Pancreaticoduodenectomy occurred.Conclusions Pancreaticoduodenectomy patients with delayed gastric emptying iscaused by a number of factors, surgical trauma is that the main mechanism for thegeneration of Postoperative gastro paresis. Hypomagnesaemia, higher Preoperative fastingblood glucose levels, Postoperative complications are other risk factors associated with theoccurrence of delayed gastric emptying. Preoperative Positive control blood sugar, hypo-pertinacious, hyperirritability, shorter operative time, less blood loss, postoperativePrevention of gastrointestinal fistula, infra-abdominal infection control measures toPrevent the occurrence of delayed gastric emptying may have Positive significance.Currently, the main obstacle for gastric emptying is a comprehensive treatment of a varietyof conservative treatment.