To investigate the risk factors and treatments for delayed gastric emptying (DGE) after pancreaticoduodenectomy (PD).

Clinical data of 45 patients developing DGE out of 395 patients undergoing PD in the First Affiliated Hospital of Xi＇an Jiaotong University between January 2009 and May 2013 were retrospectively studied. Among the 45 patients, 21 were males and 24 were females with the average age of (58±2) years old. The informed consents of all patients were obtained and the local ethical committee approval had been received. All patients were given routine postoperative monitoring and preventive antibiotics for 24-48 h. After nasogastric tube clipping and ventilation, patients were fed with a small amount of fluids, then gradually back on soft diet or normal diet in case of no abdominal distention and abdominal pain. The incidence of postoperative complications was observed.The risk factors for DGE after PD was analyzed using Logistic regression analysis.

Among the 395 patients undergoing PD, 45 developed DGE after PD with the incidence of 11.4%. Bile leakage, pancreatic fistula and intra-abdominal abscess were independent risk factors for DGE after PD (OR=9.9, 2.5, 4.2; P<0.05). The effective rate of treatment with prokinetic agents (erythromycin, metoclopramide and domperidone) was 53% (24/45). The other 21 patients who did not respond to the prokinetic agents received acupuncture therapy with the effective rate of 86% (12/14).

Bile leakage, pancreatic fistula and intra-abdominal abscess are independent risk factors for DGE after PD. DGE is a disease with multiple etiological factors. Symptoms of some patients can be improved by prokinetic agents and acupuncture therapy.