ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2021
Risk-Stratified Pancreatectomy Clinical Pathway Implementation and Delayed Gastric Emptying.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 31 citations in OpenAlex.
- Short-Term Outcomes and Cost of Robotic Versus Open Distal Pancreatectomy During the Initial Phase of a Robotic Pancreatectomy Program.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Longitudinal Symptom Recovery After Pancreatectomy: A Prospective Patient-Reported Outcomes Study using MDASI.Annals of surgical oncology · 2026Article
- Risk factors for delayed gastric emptying after pancreatoduodenectomy: a 10-year retrospective study.Annals of medicine · 2025Article
- Analysis of hospital costs for robotic and open pancreatectomy incurred during the implementation of a robotic pancreatectomy program at a cancer center.Annals of gastroenterological surgery · 2025Article
- How to Reduce Delayed Gastric Emptying After Pancreatoduodenectomy: A Systematic Literature Review and Meta-Analysis.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
- Risk stratification of clinically relevant delayed gastric emptying after pancreaticoduodenectomy.BMC surgery · 2023Article
- Comparative analysis of opioid use between robotic and open pancreatoduodenectomy.Journal of hepato-biliary-pancreatic sciences · 2023Article
- Incidence of Postoperative Complications Following Pancreatectomy for Pancreatic Cystic Lesions or Pancreatic Cancer.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Surgical treatment and survival analysis of primary duodenal malignant tumor: a retrospective cohort study.Journal of gastrointestinal oncology · 2022Article
- Association of Patient Controlled Analgesia and Total Inpatient Opioid Use After Pancreatectomy.The Journal of surgical research · 2022Article
- Risk-stratified posthepatectomy pathways based upon the Kawaguchi-Gayet complexity classification and impact on length of stay.Surgery open science · 2022Article
- Iterative Changes in Risk-Stratified Pancreatectomy Clinical Pathways and Accelerated Discharge After Pancreaticoduodenectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDelayed gastric emptying (DGE) is a frequent complication after pancreaticoduodenectomy (PD) that impairs recovery and quality of life. The purpose of this study was to assess the impact risk-stratified pancreatectomy clinical pathways (RSPCPs) had on delayed gastric emptying (DGE) and identify factors associated with DGE in a contemporary period.
methodsA single-institution, prospective database was queried for consecutive PDs during July 2011-November 2019. Using international definitions, DGE rates were compared between periods before and after RSPCPs were implemented in 2016, classifying patients according to their postoperative pancreatic fistula (POPF) risk. Risk factors were analyzed to identify modifiable targets.
resultsAmong 724 elective PDs, 552 (76%) were for adenocarcinoma and 172 (24%) for other diagnoses. Of the 197 (27%) patients with DGE, 119 (16%) had type A, 41 (6%) type B, and 38 (5%) type C. In the overall cohort, DGE rates were higher with pylorus-preserving vs. classic hand-sewn reconstruction (odds ratio [OR] - 1.84; p < 0.001), postoperative abscess (OR - 2.54; p = 0.003), and non-white patients (p = 0.007), but lower after implementation of RSPCPs (OR - 0.34, p < 0.001). In the 374 patients treated with RSPCPs, only 17% (n = 65/374) developed DGE. Patients with protocol-compliant NGT removal ≤ 48 h were less likely to experience DGE (OR - 1.46, p = 0.042).
conclusionOur data suggest that implementation of preoperatively assigned RSPCPs as a care bundle was the most important factor in decreasing DGE. These gains were accentuated in patients who underwent early nasogastric tube removal and had a classic hand-sewn gastro-jejunostomy reconstruction. Application of these modifiable factors is generalizable with low implementation barriers.
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