Delayed gastric emptying What is delayed gastric emptying: Delayed gastric emptying refers to those who cannot eat regularly or need gastrointestinal decompression after 10 days after surgery. The main causes are abdominal infection, anastomotic edema, obstruction, water and electrolyte disorders, and postoperative pancreatitis. Preoperative diabetes mellitus and malnutrition are the main risk factors for delayed gastric emptying. If the possibility of impaired gastric emptying is initially identified during the preoperative evaluation, gastrostomy and jejunostomy can be performed intraoperatively for postoperative gastrointestinal decompression and enteral nutrition, or if gastrostomy and jejunostomy are not performed intraoperatively, a nasogastric tube and jejunal nutrition tube can be placed postoperatively via the nose. The gastrostomy can be retained for a long time. Treatment of delayed gastric emptying: The principles of treatment for delayed gastric emptying are to remove the cause, continuous gastrointestinal decompression, application of gastrointestinal motility drugs and nutritional support, as well as maintaining water-electrolyte balance. When gastric emptying disorder occurs after pancreaticoduodenectomy, conservative treatment can be successful if the gastrointestinal anastomosis is confirmed to be open and intra-abdominal infection (especially in the perigastric region) or pancreatic fistula can be excluded. If an intra-abdominal infection or fistula is present, the necessary targeted drainage is required. Gastroparesis: If gastrointestinal decompression is still required 7 days after surgery and gastric drainage >800mL/d for more than 5 consecutive days, gastroparesis can be diagnosed after excluding mechanical obstruction, acid-base balance disorder, and drugs. Gastroparesis is a kind of gastric emptying disorder, with an incidence of 0.47-3.6%. It mainly manifests as epigastric discomfort, fullness and vomiting of gastric contents after eating. The treatment principle is the same as gastric emptying disorder, and most patients can recover in 3-5 weeks without surgery.