Perioperative risk factors for delayed gastric emptying after pancreaticoduodenectomy: a meta-analysis of the complications

Objective: To evaluate the correlation between the incidence of delayed gastric emptying (DGE) in pancreaticoduodenectomy (PD) and the perioperative possible risk factors. Methods: We searched PubMed, Embase, Cochrane Library, and Medline for studies describing complications related to PD from 2018 to 2022. Statistical analysis was performed using Stata/SE16.0 software. Results: In 6 retrospective studies, 1 systematic review, and 1 randomized controlled trial (RCT) experiment, 12,419 patients (2174 and 10,245 patients, respectively, in DGE and no delayed gastric emptying [NDGE] groups). The preoperative American Society of Anesthesiologists (ASA) score between DGE and NDGE groups (log odds ratio [OR] = 0.23, 95% credible interval [CI]: 0.11–0.35, P < .01), operation time (mean diff. = 21.87, 95% CI: 15.96–27.78, P < .01), estimated intraoperative blood loss (EIBL; mean diff. = 70.67, 95% CI: 17.75–123.58, P < .05), postoperative pancreatic fistula (POPF) (log OR = 0.85, 95% CI: 0.24–1.46, P < .05) were statistically significant. No significant differences in preoperative body mass index (BMI), preoperative biliary drainage, and pancreatic texture were observed (P > .05). Conclusion: The incidence of DGE is significantly correlated with the operation time, preoperative ASA score, POPF, and EIBL,which suggests that the surgeon should thoroughly evaluate the patient through adequate preoperative examination before the operation. Finally, standardized practice and perfect technology are undoubtedly necessary to reduce complications.