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Clinical validation and risk factors for delayed gastric emptying based on the International Study Group of Pancreatic Surgery (ISGPS) Classification.

 Joon Seong Park  ;  Ho Kyoung Hwang  ;  Jae Keun Kim  ;  Sin Il Cho  ;  Dong-Sup Yoon  ;  Woo Jung Lee  ;  Hoon Sang Chi 
 SURGERY, Vol.146(5) : 882-887, 2009 
Journal Title
Issue Date
Aged ; Female ; Gastric Emptying* ; Hospitals, University ; Humans ; Incidence ; Male ; Middle Aged ; Multivariate Analysis ; Pancreaticoduodenectomy/adverse effects* ; Postoperative Complications ; Retrospective Studies ; Risk Factors ; Stomach Diseases/classification ; Stomach Diseases/etiology*
BACKGROUND: Delayed gastric emptying (DGE) is one of the most common complications after pancreatoduodenectomy (PD). Because an objective, universally accepted definition of DGE does not yet exist, it is impossible to compare complication rates and outcomes of new operative approaches, operative techniques, and clinical trials. The International Study Group of Pancreatic Surgery (ISGPS) has proposed a universal classification for DGE based on clinical outcomes, but this classification has not been tested rigorously and applied to clinical data. Therefore, the aim of this study was to analyze our experience and to identify predictive factors for DGE by applying the ISGPS classification at a high-volume hospital.

METHODS: From October 2002 to December 2007, 129 consecutive patients underwent PD at the Department of Surgery, Yonsei University Medical Center. The severity of DGE was determined according to the ISGPS classification, and risk factors were evaluated retrospectively.

RESULTS: The overall incidence of DGE was 33.3%, with 16 (12.4%) patients having grade A, 14 (10.9%) grade B, and 13 (10.1%) grade C. Clinical outcomes worsened progressively as clinical relevant DGE increased. In multivariate analysis, clinically relevant pancreatic fistula (grade B/C) and patients with benign pathology were identified as independent factors for DGE.

CONCLUSION: Pancreatic leakage is a serious complication after PD and is also associated with DGE. The ISGPS classification is a clear and useful tool to assess clinical outcomes.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jae Keun(김재근)
Park, Joon Seong(박준성) ORCID logo https://orcid.org/0000-0001-8048-9990
Yoon, Dong Sup(윤동섭) ORCID logo https://orcid.org/0000-0001-6444-9606
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Cho, Shin Il(조신일)
Chi, Hoon Sang(지훈상)
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
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