Delayed gastric emptying after pancreaticoduodenectomy

Enhanced Recovery Deviation and Failure After Pancreaticoduodenectomy: Causative Factors and Impact

“…21,22 This was also the case with the incidence of clinically relevant pancreatic fistula 23 and DGE. 24 In contrast to the study by Lee et al 13 , that explores ERAS protocol failure in different hepatic and pancreatic procedures, for the first time in the academic literature we have documented the high incidence of both ERAS protocol deviation and failure focusing on PD only. 6,25 In so doing, we have also obviated the need to identify the causational factors associated with these negative outcomes.…”

Is systematic nasogastric decompression after pancreaticoduodenectomy really necessary?

“…Some authors hypothesize that DGE is the result of gastric denervation due to the loss of parasympathetic nerves, resulting in the reduction of peristaltic contractions and secretion of prokinetic drugs, such as motilin [28]. [31,32]. These results were conflicting with a previous prospective randomized trial published in 2014 by Eshuis and colleagues, where antecolic gastro-enteric anastomosis did not influence postoperative DGE [33].…”

The Vertical Array Reconstruction Technique in Pylorus-Preserving Pancreatoduodenectomy

“…We showed that the VAR technique resulted in a rate of DGE, even with PPPD, as low as 1.7%. Some reviews have reported that the antecolic route is associated with lower rates of DGE than the retrocolic route [6, 12, 13], whereas other reviews have reported that the incidence of DGE is the same [14, 15]. A large-scale, multicenter, prospective study with the same, but more clearly defined endpoints and perioperative management is needed.…”