Optimal management of delayed gastric emptying after pancreatectomy: An analysis of 1,089 patients

Joal D. Beane, Michael House, Akemi Miller, Attila Nakeeb, C. Schmidt, Nicholas Zyromski, Eugene Ceppa, David V. Feliciano, Henry A. Pitt

Research output: Contribution to journalArticle

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Abstract

Purpose The aim of this study was to determine if early recognition and treatment of delayed gastric emptying (DGE) can augment postoperative outcomes in patients undergoing pancreatectomy. Methods The International Study Group of Pancreatic Surgery definition of DGE was used to identify patients at Indiana University Hospital who required supplemental nutrition for DGE after pancreatectomy. Outcomes were compared between those without DGE, those with DGE who received supplemental nutrition within 10 days after pancreatectomy (early intervention), and those treated after 10 days (late intervention). Results Between 2007 and 2012, the incidence of DGE was 15% (n = 163/1,089), 45% (n = 73) required supplemental nutrition, including 60% (n = 44/73) in the early intervention and 40% (n = 29/73) in the late intervention groups. Postoperative morbidity (62% vs 41%; P < .01), duration of stay (16 vs 7 days; P < .01), and readmissions (41% vs 17%; P < .01) were greater among those with DGE. The early intervention group resumed a regular diet sooner (day 24 vs 36; P = .05) and were readmitted less often (25% vs 65%; P < .01) than those in the late intervention group. Treatment-related complications occurred in 14% of patients. Conclusion Patients with DGE can be managed with acceptable treatment-related morbidity. Outcomes are best when supplemental nutrition is started within 10 days of operation.

Original languageEnglish
Article number3839
Pages (from-to)939-948
Number of pages10
JournalSurgery
Volume156
Issue number4
DOIs
StatePublished - Oct 1 2014

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Pancreatectomy
Gastric Emptying
Morbidity
Therapeutics
Diet
Incidence

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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Optimal management of delayed gastric emptying after pancreatectomy : An analysis of 1,089 patients. / Beane, Joal D.; House, Michael; Miller, Akemi; Nakeeb, Attila; Schmidt, C.; Zyromski, Nicholas; Ceppa, Eugene; Feliciano, David V.; Pitt, Henry A.

In: Surgery, Vol. 156, No. 4, 3839, 01.10.2014, p. 939-948.

Research output: Contribution to journalArticle

Beane, Joal D. ; House, Michael ; Miller, Akemi ; Nakeeb, Attila ; Schmidt, C. ; Zyromski, Nicholas ; Ceppa, Eugene ; Feliciano, David V. ; Pitt, Henry A. / Optimal management of delayed gastric emptying after pancreatectomy : An analysis of 1,089 patients. In: Surgery. 2014 ; Vol. 156, No. 4. pp. 939-948.
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abstract = "Purpose The aim of this study was to determine if early recognition and treatment of delayed gastric emptying (DGE) can augment postoperative outcomes in patients undergoing pancreatectomy. Methods The International Study Group of Pancreatic Surgery definition of DGE was used to identify patients at Indiana University Hospital who required supplemental nutrition for DGE after pancreatectomy. Outcomes were compared between those without DGE, those with DGE who received supplemental nutrition within 10 days after pancreatectomy (early intervention), and those treated after 10 days (late intervention). Results Between 2007 and 2012, the incidence of DGE was 15{\%} (n = 163/1,089), 45{\%} (n = 73) required supplemental nutrition, including 60{\%} (n = 44/73) in the early intervention and 40{\%} (n = 29/73) in the late intervention groups. Postoperative morbidity (62{\%} vs 41{\%}; P < .01), duration of stay (16 vs 7 days; P < .01), and readmissions (41{\%} vs 17{\%}; P < .01) were greater among those with DGE. The early intervention group resumed a regular diet sooner (day 24 vs 36; P = .05) and were readmitted less often (25{\%} vs 65{\%}; P < .01) than those in the late intervention group. Treatment-related complications occurred in 14{\%} of patients. Conclusion Patients with DGE can be managed with acceptable treatment-related morbidity. Outcomes are best when supplemental nutrition is started within 10 days of operation.",
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AB - Purpose The aim of this study was to determine if early recognition and treatment of delayed gastric emptying (DGE) can augment postoperative outcomes in patients undergoing pancreatectomy. Methods The International Study Group of Pancreatic Surgery definition of DGE was used to identify patients at Indiana University Hospital who required supplemental nutrition for DGE after pancreatectomy. Outcomes were compared between those without DGE, those with DGE who received supplemental nutrition within 10 days after pancreatectomy (early intervention), and those treated after 10 days (late intervention). Results Between 2007 and 2012, the incidence of DGE was 15% (n = 163/1,089), 45% (n = 73) required supplemental nutrition, including 60% (n = 44/73) in the early intervention and 40% (n = 29/73) in the late intervention groups. Postoperative morbidity (62% vs 41%; P < .01), duration of stay (16 vs 7 days; P < .01), and readmissions (41% vs 17%; P < .01) were greater among those with DGE. The early intervention group resumed a regular diet sooner (day 24 vs 36; P = .05) and were readmitted less often (25% vs 65%; P < .01) than those in the late intervention group. Treatment-related complications occurred in 14% of patients. Conclusion Patients with DGE can be managed with acceptable treatment-related morbidity. Outcomes are best when supplemental nutrition is started within 10 days of operation.

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