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An Analysis of Possible Risk Factors Contributing to Delayed Gastric Emptying after Distal Gastrectomy for Gastric Cancer

Sulav P, Xin S, Ahmad HK, Xing LC, Pranita M

Gastric cancer is a worldwide epidemic. The standard and definitive treatment for gastric cancer is surgical resection: gastrectomy. Surgery is a common trigger for gastroparesis. DGE is arguably the most common of the post-gastrectomy syndromes, accounting for 5-20% of all cases. A clear etiology still remains unidentified. The purpose of the study is to analyze the possible risk factors contributing to development of DGE after distal gastrectomy for gastric cancer. A retrospective study of 252 patients, who underwent distal gastrectomy for gastric cancer, was conducted from January 2010 to December 2015. 18 patients developed DGE with an occurrence rate of 7.1%. The incidence of DGE was found to be significantly higher in patients with 1) Gastric outlet obstruction (P=0.031), 2) Roux-en-Y reconstruction surgery (P=0.041), 3) Side to end gastrojejunostomy (P=0.03), 4) Tumor in the lower 1/3rd (P= 0.027) and 5) Ulcerative lesion (P=0.001). DGE continues to affect a considerable number of patients after gastric surgery. Proper preoperative preparation and postoperative management can considerably reduce the incidence of DGE.