Evaluation of the International Study Group of Pancreatic Surgery definition of delayed gastric emptying after pancreatoduodenectomy in a high-volume centre

Welsch, Thilo; Borm, Michelle E A; Degrate, Luca; Hinz, Ulf; Büchler, Markus W.; Wente, Moritz N.

doi:10.1002/bjs.7071

Cited by 134 publications

(96 citation statements)

References 32 publications

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“…Infobox 1). Es konnte allerdings gezeigt werden, dass die Ausbildung der höheren vME-Grade mit dem Auftreten anderer postoperativer intraabdomineller Komplikationen signifikant korreliert [65]. Es kann daher vermutet werden, dass sich die Genese der unterschiedlichen vMEGrade unterscheidet und sich sekundärer vME vorwiegend in den höheren Graden der ISGPS-Klassifikation finden.…”

Section: Verzögerte Magenentleerungunclassified

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Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis

Schulze

Heidecke

2015

Chirurg

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Although the mortality associated with major hepatopancreaticobiliary surgery has continuously decreased during the last decades, the morbidity of these procedures remains high. Functional disturbances of normal gastrointestinal motility as well as inflammation and infections of surgically treated organs are frequent complications resulting in considerably prolonged lengths of stay in hospital and increased healthcare costs. This review article highlights the therapeutic approaches and recent developments in the treatment of delayed gastric emptying, prolonged postoperative ileus, postoperative cholangitis and pancreatitis after hepatopancreaticobiliary surgery. Current practice is discussed on the basis of recent results in basic and clinical research, review articles, meta-analyses and guidelines.

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Section: Verzögerte Magenentleerungunclassified

“…1 ISGPS-Konsensusdefinition der verzögerten Magenentleerung nach Pankreaseingriffen[65] ISGPS International Study Group of Pancreatic Surgery, poT postoperativer Tag.…”

unclassified

Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis

Schulze

Heidecke

2015

Chirurg

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“…DGE warrants the need for a radiological imaging to diagnose intra-abdominal collections. The incidence of DGE among different studies is 20-45 % [88][89][90][91][92]. The aetiopathogenesis of DGE has not been well understood and is multifactorial.…”

Section: Dgementioning

confidence: 99%

“…The ISGPF defined and graded DGE into three groups A,B & C [97] depending on the need for an NGT > 3 days or reinsertion for persistent vomiting after POD 3 and inability to tolerate solid diet by day 7. The current definition has been validated by many authors across the globe and is being widely followed [91,92].…”

Section: Dgementioning

confidence: 99%

Pancreatoduodenectomy - Preventing Complications

Penumadu

Barreto

Goel

et al. 2014

Indian J Surg Oncol

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Increased awareness of periampullary & pancreatic head cancers, and the accompanying improved outcomes following pancreatoduodenectomy (PD), has possibly led to an increase in patients seeking treatment for the same. While there has definitely been a reduction in morbidity rates following PD in the last few decades, this decline has not mirrored the drastic fall in mortality. Amongst the foremost in the factors responsible for this reduction in mortality is the standardization of surgical technique and development of dedicated teams to manage all aspects of this demanding procedure. This review intends to provide the reader with an overview of major complications following this major surgery and measures to prevent them based on the authors' experience.

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“…DGE after PD is one of the most frequently described specific complications [4,5] with reported incidences between 20 and 40% [6][7][8] . Its occurrence often represents a troublesome postoperative complication for patients and surgeons [9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Antecolic versus Retrocolic Gastroenteric Reconstruction after Pancreaticoduodenectomy on Delayed Gastric Emptying: A Meta-Analysis of Six Randomized Controlled Trials

Joliat

Labgaa²,

Demartines³

et al. 2015

Dig Surg

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Background: One of the most frequent complications of pancreaticoduodenectomy (PD) is delayed gastric emptying (DGE). The study aim was to evaluate the impact of the type of gastro/duodenojejunal reconstruction (antecolic vs. retrocolic) after PD on DGE incidence. Methods: A systematic review was made according to the PRISMA guidelines. Randomized controlled trials (RCTs) comparing antecolic vs. retrocolic reconstruction were included irrespective of the PD techniques. A meta-analysis was then performed. Results: Six RCTs were included for a total of 588 patients. The overall quality was good. General risk of bias was low. DGE was not statistically significantly different between the antecolic and retrocolic group (OR 0.6, 95% CI 0.31-1.16, p = 0.13). The other main surgery-related complications (pancreatic fistula, hemorrhage, intra-abdominal abscess, bile leak and wound infection) were not dependent on the reconstruction route (OR 0.84, 95% CI 0.41-1.70, p = 0.63). No statistically significant difference in terms of length of hospital stay was found between the 2 groups. There was also no difference of DGE incidence if only pylorus-preserving PD was considered and between the DGE grades A, B or C. Conclusion: This meta-analysis shows that antecolic reconstruction after PD is not superior to retrocolic reconstruction in terms of DGE.

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Evaluation of the International Study Group of Pancreatic Surgery definition of delayed gastric emptying after pancreatoduodenectomy in a high-volume centre

Abstract: The ISGPS DGE definition is feasible and applicable in patients with an uneventful postoperative course. Major postoperative complications and ICU treatment, however, might limit its usefulness. The identified risk factors for DGE are not amenable to perioperative improvement.

Cited by 134 publications

References 32 publications

Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis

Behandlung postoperativer Passagestörungen, Cholangitis und Pankreatitis

Pancreatoduodenectomy - Preventing Complications

Effect of Antecolic versus Retrocolic Gastroenteric Reconstruction after Pancreaticoduodenectomy on Delayed Gastric Emptying: A Meta-Analysis of Six Randomized Controlled Trials

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