Splenic vein resection is not a risk factor for delayed gastric emptying after pancreaticoduodenectomy with combined resection of the portal or superior mesenteric vein

Abstract

Purpose: This study clarified the influence of the splenic vein (SV) on delayed gastric emptying (DGE) in patients who underwent pancreaticoduodenectomy (PD) combined with portal vein (PV) and superior mesenteric vein (SMV) resections.

Methods: A total of 147 patients who underwent open subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) with PV/SMV resection were included in this study and classified into two groups: SV resection (n = 101) and preservation (n = 46). The incidence of DGE was compared between groups. Univariate and multivariate analyses were used to identify the risk factors for DGE.

Results: There was no significant difference in the incidence of Grade B or C DGE between the SV resection and preservation groups (19.8 vs. 19.6%, respectively; p = 0.973). Multivariate analysis revealed that intra-abdominal abscess (odds ratio, 3.355; 95% confidence interval, 1.324-8.500; p = 0.011) was the only independent risk factor for DGE.

Conclusion: SV resection did not affect the incidence of DGE after SSPPD with PV/SMV resection. There may be no need to insist on preserving the veins associated with gastric venous flow out of concern for DGE.

Keywords: Delayed gastric emptying; Pancreatic cancer; Pancreaticoduodenectomy; Portal vein; Splenic vein.