Impact of delayed gastric emptying after pancreaticoduodenectomy on survival.

BACKGROUND: Delayed gastric emptying (DGE), a common postoperative complication of pancreaticoduodenectomy, is not considered a life-threatening complication. In the present study, we analyzed the risk factors for DGE and its impact on long-term prognosis.

METHODS: We analyzed 383 patients who underwent pancreaticoduodenectomy between 2003 and 2010, dividing them into two groups according to DGE grade as defined by the International Study Group of Pancreatic Surgery: 243 without DGE (non-DGE group) and 140 with DGE of any grade (DGE group).

RESULTS: The 5-year overall survival was 32.7% in the DGE group, and 41% in the non-DGE group (P = 0.02). Cox proportional hazards analyses showed that pancreatic cancer (compared with ampulla of Vater cancer: hazard ratio [HR] 3.4, 95% confidence interval [CI] 1.82-6.34, P < 0.001), bile duct cancer (HR 2.1, 95% CI 1.08-4.06, P = 0.03), the Union for International Cancer Control stage (compared with stages I and II: HR 2.98, 95% CI 1.66-5.35, P < 0.001; compared with stage III: HR 4.71, 95% CI 2.51-8.86, P < 0.001), and DGE grade (grade C; HR 1.6, 95% CI 1.04-2.46, P = 0.03) were independent risk factors for cancer-specific survival.

CONCLUSIONS: DGE, especially grade C, negatively affects cancer-specific survival.