Werba et al reported a model for predicting delayed gastric emptying (DGE) in a patient prior to pancreaticoduodenectomy (Whipple procedure). This can help to identify a patient who should be monitored more closely. The authors are from George Washington University in Washington, DC.
Patient selection: prior to pancreaticoduodenectomy
Parameters:
(1) procedures (Pr)
(3) erythrocytes (E) preoperative RBC transfusion
(3) duct stent (D)
(4) invagination (I) = pancreatic reconstruction technique
(5) COPD (C)
(6) tobacco use (T)
(7) disease systemic (D), based on ASA
(8) gender (G)
(9) elderly (E), based on age
Procedure
Finding
Points
lysis of adhesion
no
0
yes
2
vascular reconstruction with vein graft
no
0
yes
2
feeding jejunostom7
no
0
yes
2
Parameter
Finding
Points
preoperative RBC transfusion
no
0
yes
2
duct stent
no
1
yes
0
pancreatic reconstruction
none
0
invagination
1
pylorus preserving Whipple with pancreaticogastrostomy
2
COPD
no
0
yes
2
tobacco use
no
1
yes
0
ASA
1 or 2
0
3 to 5
1
gender
male
1
female
0
age in years
<= 70 years
0
> 70 years
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 17
Total Score
Risk Group
Percent Delayed Gastric Emptying
0 to 2
low
11%
3 or 4
intermediate
15%
>= 5
high
23%
Performance:
• The area under the ROC curve is 0.69.
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