{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T13:24:24Z","timestamp":1707917064638},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2005,6,16]],"date-time":"2005-06-16T00:00:00Z","timestamp":1118880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2005,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Literature reports indicate that the incidence of delayed gastric emptying (DGE) is higher after pylorus\u2010preserving pancreaticoduodenectomy (PPPD) than after conventional pancreaticoduodenectomy (CPD), but DGE is traditionally diagnosed from patient\u2010reported subjective sensations. Our clinical radiological experience suggests higher rates for physiological DGE post\u2010CPD. We therefore sought to quantify rates of subjective DGE (sDGE, based on patient complaint) verses objective DGE (oDGE, based on scintography) post\u2010CPD and post\u2010PPPD. Contractile motility of post\u2010PPPD residual stomach was also studied. For 21\u00a0PPPD and 33 CPD patients between October 1997 and June 2000, sDGE and oDGE data were collected preoperatively, on postoperative day 14, and 6\u00a0months postoperatively, with cholescintography for pylorus ring competency on postoperative day 14. The incidence of sDGE was higher for PPPD (42%) than for CPD (15%) at 14\u00a0days, with zero sDGE for both at 6\u00a0months. The incidence oDGE was higher for CPD (91%) than for PPPD (76%) at 14\u00a0days, with a 6\u2010month incidence of 4.7% in PPPD but ~33% for CPD. Solid\u2010phase emptying in PPPD showed that residual stomach retained partial gastric emptying function at 14\u00a0days but not at 6\u00a0months. Cholescintography showed abnormal pylorus closure function in 2 of 21\u00a0PPPD patients but was not related to DGE. Literature reports of higher DGE incidence post\u2010PPPD are true only for subjective symptoms. Radiological measurement of oDGE shows that both CPD and PPPD manifest ~80% incidence of DGE in the early postoperative period. At 6\u00a0months, ~33% of CPD show persistent oDGE. We concluded that (1) the concept of DGE should distinguish between subjective and objective symptoms; (2) loss of distal stomach mechanoreceptors in CPD reduces patients sensation of oDGE, producing \u201csilent\u201d DGE;(3) both CPD and PPPD have high and approximately equal rates oDGE;(4) the previously unnoticed silent oDGE in CPD may contribute to the higher rates of ulceration and related morbidity in association with CPD<\/jats:p>","DOI":"10.1007\/s00268-005-7473-1","type":"journal-article","created":{"date-parts":[[2005,6,10]],"date-time":"2005-06-10T19:33:03Z","timestamp":1118431983000},"page":"873-879","source":"Crossref","is-referenced-by-count":13,"title":["Reconsideration of Delayed Gastric Emptying in Pancreaticoduodenectomy"],"prefix":"10.1002","volume":"29","author":[{"given":"Yan\u2010Shen","family":"Shan","sequence":"first","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University 138, Shene\u2010Li Road Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei\u2010Ling","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Physiology, College of Medicine, National Cheng Kung University 138, Sheng\u2010Li Road 704 Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan\u2010Tsing","family":"Chiu","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University 138, Sheng\u2010hi Road Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pin\u2010Wen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Surgery National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University 138, Shene\u2010Li Road Tainan Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2005,6,16]]},"reference":[{"key":"e_1_2_10_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-194506000-00008"},{"key":"e_1_2_10_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.18003112406"},{"key":"e_1_2_10_4_2","first-page":"959","article-title":"Preservation of the pylorus in pancreaticoduodenectomy","volume":"146","author":"Traverse LW","year":"1978","journal-title":"Surg. 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