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Clinical Efficacy of the Preservation of the Hepatic Branch of the Vagus Nerve on Delayed Gastric Emptying After Laparoscopic Pancreaticoduodenectomy
- Source :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract. 25(8)
- Publication Year :
- 2021
-
Abstract
- Delayed gastric emptying (DGE) is a common complication following laparoscopic pancreaticoduodenectomy (LPD), although it remains incompletely understood, and only few studies have investigated the clinical benefits of hepatic branch of the vagus nerve (HBVN) preservation on DGE after LPD until now. We intended to evaluate the effect of preservation of the HBVN during LPD on the incidence of DGE. A total of 274 consecutive LPDs performed at a single center between July 2014 and December 2019 with available videos were retrospectively reviewed. DGE was defined according to the International Study Group of Pancreatic Surgery (ISGPS) criteria, and HBVN condition during the LPD procedure was evaluated through a video review. Risk factors associated with DGE were assessed by performing univariate and multivariate logistic regression analyses. Postoperative outcomes between the HBVN-preserved and HBVN-injury groups were compared before and after propensity score matching (PSM). One hundred fifty-six (56.93%) patients underwent LPD with HBVN-preserved and 118 (43.07%) with HBVN injury. DGE occurred in 33.2% of patients (n = 91) with grades B and C occurring at 13.9% (n = 38) and 7.7% (n = 21), respectively. Longer operative time, more EIBL, HBVN injury, POPF (grades B and C), postoperative hemorrhage, intra-abdominal infection, and Clavien-Dindo ≥III were identified as risk factors for DGE in the univariate analysis. Then, in the multivariate analysis, HBVN injury and intra-abdominal infection were found to be independent risk factors affecting the incidence of DGE (any grade) or clinically relevant DGE (grades B and C). Furthermore, the prevalence of DGE was significantly higher in the HBVN-injury group than in the HBVN-preserved group before and after PSM analysis (46.61% vs. 23.08%, P
- Subjects :
- medicine.medical_specialty
Multivariate analysis
Gastroparesis
030230 surgery
Logistic regression
Single Center
Gastroenterology
Pancreaticoduodenectomy
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Risk Factors
Internal medicine
medicine
Humans
Prospective Studies
Retrospective Studies
Univariate analysis
Gastric emptying
business.industry
Incidence (epidemiology)
fungi
Vagus Nerve
Treatment Outcome
Gastric Emptying
030220 oncology & carcinogenesis
Propensity score matching
Surgery
Laparoscopy
Complication
business
Subjects
Details
- ISSN :
- 18734626
- Volume :
- 25
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
- Accession number :
- edsair.doi.dedup.....282f1d1569f29c51e482a2d8edd837c1