Risk Factors Of Postsurgical Gastroparesis Syndrome After Pancreaticoduodenectomy:A Meta-analysis

Objective:To explore the risk factors of Postsurgical Gastroparesis Syndrome after pancreatoduodenectomy by Meta-analysis, and provide a theoretical basis to reduce the incidence of Postsurgical Gastroparesis Syndrome.Methods: A systematic search of Cochrane Library,PUBMED,CNKI,VIP and Wan Fang databases from January 1996 to December 2015 was performed to identify articles about risk factors of PGS and finally 15 studies were enrolled into this analysis.After quality assessment and data extraction of all articles,a meta-analysis was performed with Review Manager 5.3 for statistic analysis.Results:Fifteen studies were collected,involving 3397 cases in total.The results of meta-analysis showed that there were no significant differences in age,gender,preoperative hypertension complication,preoperative diabetes mellitus complication,vascular resection,properties of tumor(P>0.05). But the results showed that preoperative jaundice(OR =1.42,95% CI:1.02 ~1.98,P<0.05), retrocolic enteric reconstruction(OR =0.46,95% CI:0.22 ~0.95,P<0.05),preservation of pylorus(OR =1.72,95% CI:1.21 ~2.46,P<0.05),postoperative albumin(OR =0.55,95% CI:0.31 ~0.98,P<0.05),postoperative pancreatic fistula(OR =3.69,95% CI:2.56 ~5.31,P<0. 00001),intraabdomianal infection(OR =6.26, 95% CI:2.99 ~ 13.08, P < 0. 00001)and postoperative abdominal complications(OR =3.71,95% CI:2.42 ~5.69,P<0. 00001)were risk factors of PGS.Conclusion: Preoperative jaundice,retrocolic enteric reconstruction,preservation of pylorus,postoperative albumin,postoperative pancreatic fistula,intraabdomianal infection and postoperative abdominal complications are risk factors associated with PGS. There was no significant association between the PGS and age,gender,preoperative hypertension complication,preoperative diabetes mellitus complication,vascular resection,properties of tumor.