A Retrospective Study And Clinical Analysis Of Risk Factors Of Gastroparesis Syndrome After Subtotal Gastrectomy

Objective:This study was undertake to study the cases of gastroparesis syndrome after subtotal gastrectomy in our department, and to study the possible risk factors which influence the development of postoperative gastroparesis,and dertemine the preventive measure of it.Methods:PGS (postsurgical gastroparesis syndrome) was defined as non-gastric drainage for more 7 days or naso-gastric tube's reinsertion because of vomiting.we studied 508 consecutive patients who underwent subtotal gastrectomy in our department between 2000 and 2009.Then we divide those patients into two groups as gastroparesis group or not.The variables analyzed were age,gender,diabetes, operative time,laboratory data, complications,use of stapler and so on.Chi-squarede test,Fisher's exact test, Student's-test and logistic regression analysis were used.Results:There were 28 patients occurred postoperative gastroparesis syndrome after subtotal gastrectomy. Onset time was 4d-8d after surgery, many patients present symptoms when patients consume liquid or semi-liquid diet, performance as abdominal fullness, dull pain, belching acid reflux, then vomiting of food with gastric juices and bile. All patients were cured with conservative treatment, Recovery time was 11d-51d after surgery, an average of 22 d. Univariate analysis showed that preoperative pyloric obstruction, billrothâ…¡'s gastrointestinal anastomosis, postoperative complications, perioperative high blood sugar, preoperative low-protein are the risk factors of postoperative gastroparesis syndrome. Logistic Regression analysis showed that preoperative pyloric obstruction, billrothâ…¡'s gastrointestinal anastomosis, postoperative abdominal complications, postoperative high blood sugar are the risk factors of postoperative gastroparesis syndrome.Conclusions:Gastroparesis syndrome after subtotal gastrectomy is caused by several factors. Billrothâ…¡'s anastomosis, postoperative complications, postoperative high blood sugar is related to postoperative gastroparesis syndrome. For the risk factors, appropriate use of interventions,can effectively reduce the occur of gastroparesis syndrome after subtotal gastrectomy. Clinically, gastroparesis syndrome after subtotal gastrectomy because of surgery and trauma,can be defined as delayed gastric emptying. Presently, their timely and accurate clinical diagnosis was still difficult, treatment is still mainly to support the resumption. In the course of treatment, other than mechanical obstruction, the patience is very important.