Incidence of delayed gastric conduit emptying after esophagectomy: a retrospective single-center study

Delayed gastric conduit emptying (DGCE) after esophagectomy is a major cause of morbidity and reduced quality of life. The reported incidence varies greatly (2.2-47%), partly due to a lack of consensus on the definition of DGCE. Recently, an international expert consensus proposed diagnostic criteria for Early-DGCE (E-DGCE) and Late-DGCE (L-DGCE) alongside a symptom severity score. Using these criteria, we investigated the incidence and predictors of DGCE in a large cohort. All patients undergoing esophagectomy with pyloroplasty at Rigshospitalet, Denmark, between 2016 and 2021 were reviewed. E- and L-DGCE were defined using the proposed criteria (5-14 days and > 14 days after surgery, respectively). Specialist nurses followed patients for up 2 years at predefined intervals. About 387 patients were included. The incidence of E-DGCE was 174/387 (45%), and 155/387 (40%) patients presented with L-DGCE at least once during follow-up. The highest prevalence of L-DGCE (19.6%) was identified at postoperative day 28 (POD28) but decreased to 2.9% at the 2-year follow-up. A BMI of ≥30 was a predictor of E-DGCE (P = 0.004) and L-DGCE at POD28 (P = 0.01). No association between E-DGCE and L-DGCE was identified. Using the proposed criteria, the incidence of E-DGCE and prevalence of L-DGCE at POD28 was high. The prevalence of L-DGCE was dynamic but decreased greatly during follow-up. Future prospective studies with multiple follow-ups are needed to validate our findings and the usefulness of the criteria in a clinical setting.