Abstract
Background
Proton pump inhibitors (PPIs) are effective in reducing marginal ulcers after pancreatoduodenectomy.
However, their impact on perioperative complications has not been defined.
Methods
We retrospectively analyzed the effect of postoperative PPIs on 90-day perioperative
outcomes in all patients who underwent pancreatoduodenectomy at our institution from
April 2017 to December 2020.
Results
284 patients were included; 206 (72.5%) received perioperative PPIs, 78 (27.5%) did
not. The two cohorts were similar in demographics and operative variables. Postoperatively,
the PPI cohort had significantly higher rates of overall complications (74.3% vs.
53.8%) and delayed gastric emptying (28.6% vs. 11.5%), p < 0.05. However, no differences
in infectious complications, postoperative pancreatic fistula, or anastomotic leaks
were seen. On multivariate analysis, PPI was independently associated with a higher
risk of overall complications (OR 2.46, CI 1.33–4.54) and delayed gastric emptying
(OR 2.73, CI 1.26–5.91), p = 0.011. Four patients developed marginal ulcers within
90-days postoperatively; all were in the group who received PPIs.
Conclusion
Postoperative proton pump inhibitor use was associated with a significantly higher
rate of overall complications and delayed gastric emptying after pancreatoduodenectomy.
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Article info
Publication history
Published online: February 23, 2023
Accepted:
February 21,
2023
Received:
January 17,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.
