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Lookup NU author(s): Dr Keno Mentor, Professor Sanjay PandanaboyanaORCiD
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background: Delayed gastric emptying (DGE) is a frequent complication after pancreaticoduodenectomy (PD). The diagnosis of DGE is based on International Study Group for Pancreatic Surgery (ISGPS) clinical criteria and objective assessments of DGE are infrequently used. The present literature review aimed to identify objective measures of DGE following PD and determine whether these measures correlate with the clinical definition of DGE.Methods: A systematic search was performed using the MEDLINE Ovid, EMBASE, Google Scholar and CINAHL databases for studies including pancreatic surgery, delayed gastric emptying and gastric motility until June 2022. The primary outcome was modalities undertaken for the objective measurement of DGE following PD and correlation between objective measurements and clinical diagnosis of DGE. Relevant risk of bias analysis was performed.Results: The search revealed 4881 records, of which 46 studies were included in the final analysis. There were four objective modalities of DGE assessment including gastric scintigraphy (n = 28), acetaminophen/paracetamol absorption test (n = 10), fluoroscopy (n = 6) and the 13C-acetate breath test (n = 3). Protocols were inconsistent, and reported correlations between clinical and objective measures of DGE were variable; however, amongst these measures, at least one study directly or indirectly inferred a correlation, with the greatest evidence accumulated for gastric scintigraphy.Conclusion: Several objective modalities to assess DGE following PD have been identified and evaluated, however are infrequently used. Substantial variability exists in the literature regarding indications and interpretation of these tests, and there is a need for a real-time objective modality which correlates with ISGPS DGE definition after PD.
Author(s): Wang Tim, Lin Anthony, Mentor Keno, O'Grady G, Pandanaboyana S
Publication type: Article
Publication status: Published
Journal: World Journal of Surgery
Year: 2023
Volume: 47
Issue: 1
Pages: 236-259
Print publication date: 01/01/2023
Online publication date: 23/10/2022
Acceptance date: 24/09/2022
Date deposited: 05/06/2024
ISSN (print): 0364-2313
ISSN (electronic): 1432-2323
Publisher: John Wiley & Sons, Inc.
URL: https://doi.org/10.1007/s00268-022-06784-7
DOI: 10.1007/s00268-022-06784-7
PubMed id: 36274094
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