DELAYED GASTRIC EMPTYING AFTER PANCREATIC SURGERY - A REPORT OF TWO CASES
Main Article Content
Abstract
Background: Pancreatic surgery is highly complex and associated with a high complication rate (30–60%). Among these, delayed gastric emptying (DGE) is a common complication that significantly affects recovery time, treatment costs, and patient outcomes.
Objectives: To analyze the clinical characteristics of two cases of DGE following pancreatic surgery and to review the literature in order to clarify the pathophysiology, risk factors, and management strategies of this complication.
Methods: We report two cases of DGE following pancreatic surgery (pancreaticoduodenectomy and distal pancreatectomy). Clinical data, imaging findings, postoperative course, and treatment outcomes were collected and analyzed, along with a literature review.
Results: Both patients developed DGE postoperatively, presenting with vomiting and poor oral intake tolerance. One case had a severe and prolonged course requiring reoperation with gastrojejunostomy and jejunostomy; the other responded well to conservative management combined with drainage of intra-abdominal fluid collections. Contributing factors included inflammation, intra-abdominal fluid collections, and the impact of surgery on gastric neural and hormonal regulation.
Conclusions: DGE is a multifactorial complication following pancreatic surgery, involving hormonal (loss of motilin), neural (vagal nerve injury), mechanical, and secondary inflammatory mechanisms. Distinguishing between primary and secondary DGE is crucial for appropriate management. Treatment strategies should combine nutritional support, prokinetic agents, and management of underlying causes (such as drainage of fluid collections).
Keywords
Delayed gastric emptying, pancreatic surgery, postoperative complications, pancreaticoduodenectomy, DGE
Article Details
References
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