Analysis Of The Influence Factors Of Delayed Gastric Emptying After Pancreaticoduodenectomy

Objective: To study the influence factors of gastric emptying delay(DGE)after pancreaticoduodenectomy(PD),and provide support for the prevention and treatment of DGE.Methods: This study analyzed the clinical data of 50 patients with PD in the third central hospital of tianjin from January 1,2017 to December 31,2017.According to diagnostic criteria of DGE we divided the patients into the DGE group and the non-DGE group,and compared the patients’ age,gender,preoperative hemoglobin,preoperative total protein,preoperative albumin,preoperative prealbumin,total bilirubin,diabetes mellitus,preoperative cholangitis,high blood pressure,preoperative anxiety score,intraoperative blood loss,operating time,the way of gastrointestinal anastomosis,brown anastomosis,postoperative hemoglobin,postoperative albumin,the complication of biliary fistula,pancreatic fistula,abdominal cavity infection,postoperative anxiety score of the two groups.t test andχ2 test were used respectively to compare the measurement data and categorical data.After the analysis of single and multivariate factors Logistic regression,the influence factors of DGE were obtained.Therefore,on the basis of the anxious state judge standard,we divided the patients into anxiety group and non-anxiety group,and further compared the clinical parameters and DGE mobidity between two groups.We also evaluated the influence of preoperative and postoperative anxiety state on DGE after PD.Results: There was 16 cases with DGE in 50 PD patients.The incidence was 32.0%.By comparing the clinical parameters,we found the age,preoperative anxiety score,abdominal cavity infection rate after operation and postoperative anxiety score in anxiety group were significantly higher than that in non-anxiety groups(P<0.05).By the single factor Logistic analysis,we found that the age more than 60 years,preoperative anxiety score,abdominal cavity infection rate after operation and postoperative anxiety score were influence factors of DGE after PD,moreover,by multiariable Logistic regression analysis,it was concluded that the age more than 60 years,preoperative anxiety score,abdominal cavity infection rate after operation andpostoperative anxiety score were risk factors for postoperative DGE(OR>1).There were no significant differences in the clinical data between preoperative or postoperate anxiety group and the control group(P>0.05).The postoperative DGE morbidity of preoperative or postoperate anxiety group was significantly higher than that of the control group(P<0.05).Conclusion: The DGE after PD was correlated with the age more than 60 years,preoperative anxiety score,abdominal cavity infection rate after operation and postoperative anxiety scores.The patients should be paid more attention to the preoperative or postoperative psychological state and given the active intervention.