Purpose

The aim of this study is to investigate the utility of gastrostomy tube (G-tube) placement in reducing delayed gastric emptying (DGE) among patients undergoing pancreaticoduodenectomy (PD).

Methods

We retrospectively reviewed consecutive patients undergoing PD from 2015 to 2020 at our institution. Thirty-day patient outcomes including DGE, length of stay (LOS), reoperation rates, and morbidity were analyzed in patients with or without G-tube placement.

Results

128 patients with resectable pancreatic head cancer (54 females, median age 68.50 [59.00–74.00]) underwent PD (66 had G-tube placement and 62 did not). There was no significant difference in the incidence of DGE (n = 17 vs. n = 17, p = 0.612), and LOS between the groups. Postoperative ileus (p = 0.007) was significantly lower while atrial fibrillation (p = 0.037) was higher among the G-tube group. Gastrostomy-related complications (p = 0.001) developed in ten patients: skin-related complications (n = 6), tube dislodgement (n = 3) and clogging (n = 1). Nine patients required reoperation during index admission (n = 4 vs. n = 5, p = 1.000). There was no difference in 30-day readmissions (n = 7 vs. n = 5, p = 0.471) and no difference in 30 or 90-day mortality.

Conclusion

Gastrostomy tube placement during index PD did not affect the incidence of DGE. However, patients experienced significant morbidities due to G-tube-related complications. Placement of gastrostomy tubes at the index PD offers no clinical benefits.

中文翻译：

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胰十二指肠切除术时放置胃造口管的效用

目的

本研究的目的是探讨胃造口管 (G 管) 放置在减少接受胰十二指肠切除术 (PD) 的患者胃排空延迟 (DGE) 方面的效用。

方法

我们回顾性地回顾了 2015 年至 2020 年在我们机构接受 PD 的连续患者。对放置或未放置 G 管的患者的 30 天患者结局进行分析，包括 DGE、住院时间 (LOS)、再手术率和发病率。

结果

128 名可切除胰头癌患者（54 名女性，中位年龄 68.50 [59.00–74.00]）接受了 PD（66 名放置 G 管，62 名未放置）。 各组之间DGE 的发生率（ n  = 17 vs. n  = 17，p = 0.612）和 LOS发生率无显着差异。 G 管组术后肠梗阻 ( p  = 0.007) 显着降低，而心房颤动 ( p = 0.037) 较高。10 名患者出现胃造口相关并发症 ( p  = 0.001)：皮肤相关并发症 ( n  = 6)、管移位 ( n  = 3) 和堵塞 ( n  = 1)。9 名患者在首次入院期间需要再次手术（n  = 4 vs. n  = 5，p  = 1.000）。30 天再入院率没有差异（n  = 7 与n  = 5，p  = 0.471），30 或 90 天死亡率也没有差异。

结论

PD 期间放置胃造口管并不影响 DGE 的发生率。然而，由于 G 管相关并发症，患者出现了显着的发病率。将胃造口管放置在 PD 指数处没有任何临床益处。