Treatment Modalities and the Role of Endoscopy for Delayed Gastric Emptying After Whipple Operation: Analysis of 53 Patients
| العنوان: | Treatment Modalities and the Role of Endoscopy for Delayed Gastric Emptying After Whipple Operation: Analysis of 53 Patients |
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| المؤلفون: | Volkan Oter, Yigit Mehmet Ozgun, Tahsin Dalgic, Erdal Birol Bostanci, Muhammet Kadri Çolakoğlu, Erol Aksoy, Osman Aydin, Erol Pişkin |
| المصدر: | The American Surgeon. 88:273-279 |
| بيانات النشر: | SAGE Publications, 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Food intake, medicine.medical_specialty, Abdominal Abscess, Gastroparesis, Time Factors, medicine.medical_treatment, 030230 surgery, Endoscopy, Gastrointestinal, Pancreaticoduodenectomy, Whipple Procedure, Eating, Pancreatic Fistula, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Humans, Medicine, Prospective Studies, Intubation, Gastrointestinal, Gastric emptying, medicine.diagnostic_test, business.industry, fungi, General Medicine, Length of Stay, Surgery, Endoscopy, Whipple operation, Treatment modality, 030220 oncology & carcinogenesis, business, Endoscopic treatment |
| الوصف: | Background Delayed gastric emptying (DGE) is one of the most common complications after Whipple surgery. This situation delays postoperative oral food intake and prolongs hospitalization. Postoperative DGE often develops due to complications such as intra-abdominal abscess, collections, and anastomosis leaks, and these are called secondary DGE. The pathogenesis of primary DGE is still unknown, and there are insufficient data in the literature about the treatment. In this study, patients undergoing Whipple operation were examined separately as primary and secondary DGE. We discussed the causes and treatments of these patients, and also we aimed to present the therapeutic effect of endoscopy for primary DGE after the Whipple procedure. Methods From March 2014 to March 2018, data of 262 patients who underwent the Whipple procedure were collected prospectively. We observed that postoperative DGE developed in 53 (21.7%) patients. We retrospectively divided the patients by etiology into 2 groups as primary and secondary and graded DGE according to the International Study Group of Pancreatic Surgery. We defined patients who did not have secondary causes such as intra-abdominal abscess as primary DGE. Appropriate interventional procedures were performed for patients with secondary causes. We performed endoscopic intervention with therapeutic intent for patients who had primary DGE. Results The overall rate of DGE was 21.7% (n = 53) among 262 patients undergoing the Whipple procedure. It was observed that in 31 (58.5%) of these 53 patients, DGE was developed due to secondary causes. Interventional procedures were performed to these patients when necessary. A total of 22 (41.5%) patients developed primary DGE. Of these, 9 patients were grade A, 7 were grade B, and 6 were grade C. The mean duration of hospitalization for secondary DGE and primary DGE was 20.36 and 28.7 days, respectively. After endoscopic intervention with therapeutic intent to primary DGE patients, we observed that patients tolerated solid meal after 12 hours in grade B and after 26 hours in grade C patients. Conclusion Delayed gastric emptying, which is a common complication after Whipple operation and which deteriorates the quality of life and prolongs the duration of hospital stay, should be treated according to the cause. In secondary DGE, treatment modalities must be focused on intra-abdominal causes such as hematoma, collection, and abcess. We suggest that the primary DGE which is unresponsive to medical treatments could be treated endoscopically. After endoscopic intervention, patients with primary DGE can be started oral intake on the same day and discharged more quickly. |
| تدمد: | 1555-9823 0003-1348 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::4a9e8549fe98f357f232e6015c722c03 https://doi.org/10.1177/0003134821989037 |
| حقوق: | CLOSED |
| رقم الأكسشن: | edsair.doi.dedup.....4a9e8549fe98f357f232e6015c722c03 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15559823 00031348 |
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