{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:18:59Z","timestamp":1761178739816,"version":"build-2065373602"},"reference-count":39,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T00:00:00Z","timestamp":1728604800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 81802463","No. 81972314"],"award-info":[{"award-number":["No. 81802463","No. 81972314"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["UEG Journal"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Currently, there is still a lack of an accurate predictive model for delayed gastric emptying (DGE) following pancreaticoduodenectomy (PD) in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to develop a concise model that could effectively predict the risk of DGE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included a training cohort of 1251 consecutive PDAC patients who underwent PD from the US multicenter ACS\u2010NSQIP database. Additionally, a validation cohort of 934 consecutive PDAC patients who underwent PD was included from the National Cancer Center in China. A total of 46 perioperative indicators were incorporated in the analysis. The DGE risk stratification (DGERS) model was then developed and validated using Lasso\u2010logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After screening using Lasso\u2010logistic regression, we identified four independent predictors that were significantly correlated with DGE: days to pancreatic drain removal (HR, 1.05; 95% CI, 1.02\u20131.08;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), pancreatic fistula (HR, 2.61; 95% CI, 1.65\u20134.12;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), sepsis\/septic shock (HR, 2.46; 95% CI, 1.52\u20133.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and reoperation (HR, 4.16; 95% CI, 2.27\u20137.57;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Based on these factors, we developed a nomogram to predict postoperative DGE. The model demonstrated excellent calibration and optimal performance in the validation cohorts (AUC, 0.73; 95% CI, 0.67\u20130.73). In the validation cohort, the DGERS exhibited significant risk stratification ability, with AUC values of 0.7, 0.61, and 0.74 for the low\u2010, moderate\u2010, and high\u2010risk groups, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study identified four factors that independently increased the occurrence of DGE in patients with PDAC after PD, including days to pancreatic drain removal, pancreatic fistula, sepsis\/septic shock, and reoperation. Based on these findings, we developed a personalized and straightforward DGERS that enables dynamic and precise prediction of DGE risk, allowing for effective stratification of individuals based on their risk profiles.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ueg2.12688","type":"journal-article","created":{"date-parts":[[2024,10,11]],"date-time":"2024-10-11T12:35:04Z","timestamp":1728650104000},"page":"614-630","source":"Crossref","is-referenced-by-count":2,"title":["Delayed gastric emptying risk stratification in patients with pancreatic ductal adenocarcinoma after pancreatoduodenectomy: An international validation cohort study"],"prefix":"10.1002","volume":"13","author":[{"given":"Zongting","family":"Gu","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary &amp; Pancreatic Surgery and Minimally Invasive Surgery Zhejiang Provincial People's Hospital Affiliated People's Hospital Hangzhou Medical College  Hangzhou Zhejiang China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongxing","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgery National Cancer Center\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunjie","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of General Surgery Beijing Hospital National Center of Gerontology Institute of Geriatric Medicine Chinese Academy of Medical Sciences  Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohao","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Pancreatic and Gastric Surgery National Cancer Center\/Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College  Beijing 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