Sepsis delays gastric emptying following pylorus-preserving pancreaticoduodenectomy

Background/Aims: The mechanism of delayed gastric emptying following pylorus-preserving pancreaticoduodenectomy is not completely understood. Methodology: The records of 25 patients who underwent pylorus-preserving pancreaticoduodenectomy were reviewed. Correlations of postoperative delayed gastric emptying defined as the need for postoperative nasogastric decompression for >10 days, with perioperative parameters and clinical outcome were analyzed. Results: Delayed gastric emptying occurred in 13 patients. Age, gender, presence of pancreatic carcinoma, operating time, estimated blood loss, and preservation of right gastric artery did not affect the incidence of delayed gastric emptying. Patients with pancreatic fibrosis (n=13) had a significantly lower incidence of delayed gastric emptying than in those without fibrosis (n=12) (23% us. 83%, P=0.0048). Ten patients developed postoperative septic complications, including anastomotic leakage (n=7), pneumonia (n=2), and severe wound infection (n=1). The incidence of postoperative delayed gastric emptying was significantly higher in patients with septic complications than in those without septic complications (100% us. 20%, P=0.0001). Also, patients with intra-abdominal sepsis had a significantly higher incidence of delayed gastric emptying (P=0.0052). Conclusions: Delayed gastric emptying following pylorus-preserving pancreaticoduodenectomy is related to the presence of non-fibrotic pancreas and postoperative septic complications.