Value of Scintigraphy for Assessing Delayed Gastric Emptying After Pancreatic Surgery |
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Authors: | Gan van Samkar Wietse J Eshuis Marike Lemmers Dirk J Gouma Roel J Bennink Markus W Hollmann Marcel G W Dijkgraaf Olivier R C Busch |
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Institution: | 1. Department of Anesthesiology, Academic Medical Center, University of Amsterdam, H1-112, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands 2. Department of Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 3. Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands 4. Clinical Research Unit, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Abstract: | Background Delayed gastric emptying (DGE) occurs frequently after pancreatic surgery. Recently a consensus definition of DGE was introduced, and this grading system is currently widely used. The aim of this study was to compare results of gastric emptying scintigraphy with the grade of DGE after pancreatic surgery. Methods In 44 patients undergoing exploration for a pancreatic head or periampullary tumor, 28 pancreatoduodenectomies (PDs) and 16 double-bypass procedures were performed. All patients underwent preoperative and postoperative gastric emptying scintigraphy. We investigated whether the incidence of DGE was correlated with the results of gastric emptying scintigraphy. Results DGE occurred in 19 (43 %) patients. Clinically relevant DGE (grades B and C) prevailed in the PD group. Median postoperative residual activity at t = 2 h (%RA120) in these groups was 36 % (no DGE), 75 % (grade A), 93 % (grade B), and 95 % (grade C). DGE grade B or C was found in 7 of 10 patients with %RA120 of ≥94 % on postoperative day (POD) 7. Conclusions Postoperative %RA120 on scintigraphy is positively associated with severity of DGE. Gastric emptying scintigraphy on POD 7 can predict the severity of DGE. When postoperative gastric emptying scintigraphy shows high residual radioactivity, the likelihood of further progression to grade B or C DGE is high and warrants investigation for underlying causes. |
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