The impact of prevention of delayed gastric emptying on long-term prognosis and nutritional status after pancreaticoduodenectomy: a single-center retrospective cohort study

Abstract Background Delayed gastric emptying (DGE) remains an unsolved complication after pancreaticoduodenectomy (PD). The aim of this study was to evaluate the effectiveness of a modified reconstruction technique -anchored straight stomach reconstruction (ASSR) - in reducing the incidence of DGE, and its impact on survival after PD. Methods A retrospective analysis of 121 consecutive PD patients was conducted: 100 of them had undergone ASSR and the remaining 21 had undergone conventional modified Child method of reconstruction. The two groups were then compared with regard to the incidence of DGE and long-term outcome including postoperative nutritional status. Results The incidence of significant DGE in the ASSR group (5%) was significantly lower than that in the conventional group (29%) (p < 0.001). The 5- and 10-year overall survival rates were significantly better in the ASSR group (60% and 49%, respectively) than in the conventional group (45% and 9%, respectively) (p = 0.024). Multivariate analyses showed that the type of reconstruction (ASSR or conventional) was a significant independent post-PD prognostic factor (p = 0.001). Comparison of nutritional status showed that ASSR facilitated a prompt recovery of body weight (BW) and serum albumin level at 6 months after PD. At 12 months after PD, BW gain was significantly better in the ASSR group than in the conventional group (p = 0.032). Conclusion Anchored straight stomach reconstruction is able to reduce the incidence of DGE in patients undergoing PD. The prevention of DGE by ASSR might improve their nutritional status, possibly resulting in a better survival rate after PD.