Our Summary

This paper discusses a common problem after esophagus surgery (esophagectomy), namely Delayed Gastric Conduit Emptying (DGCE). This is when food does not pass through the stomach and into the intestine as quickly as it should, which can cause discomfort and negatively impact a person’s quality of life. The study aimed to find out how often this problem actually happens, but found a lot of inconsistency in the reported rates. They found this inconsistency was largely due to different diagnostic criteria being used.

The researchers looked at 125 different studies, and concluded that roughly 16% of patients experienced DGCE shortly after surgery, while around 9% had the issue later on. They also found that a preventative measure often used, called prophylactic pyloric drainage, didn’t significantly affect the rates of DGCE.

The researchers concluded that DGCE is a significant issue for people who’ve had esophagus surgery. They also stressed the need for a standardized way to diagnose this condition to reduce inconsistency in reported rates, and to better identify and manage it. They suggest adopting a recently published international consensus definition for this purpose.

FAQs

  1. What is Delayed Gastric Conduit Emptying (DGCE)?
  2. How often does DGCE occur after esophagectomy according to the study?
  3. What measures were suggested by the researchers to manage and diagnose DGCE more effectively?

Doctor’s Tip

One helpful tip a doctor might tell a patient about esophagectomy is to be aware of the potential for delayed gastric conduit emptying and to communicate any symptoms or concerns with their healthcare provider promptly. It is important to follow up regularly with your healthcare team after surgery to monitor for any potential complications and ensure proper management if issues arise. Additionally, maintaining a healthy diet and following any dietary guidelines provided by your healthcare team can help to prevent or alleviate symptoms related to delayed gastric conduit emptying.

Suitable For

Patients who are typically recommended esophagectomy include those with esophageal cancer, Barrett’s esophagus, severe esophageal strictures, or other conditions that affect the esophagus and cannot be managed effectively with less invasive treatments.

Timeline

Before esophagectomy:

  1. Patient will undergo various tests and evaluations to determine the need for surgery, such as endoscopy, imaging studies, and blood tests.
  2. Patient will meet with the surgical team to discuss the procedure, risks, and recovery process.
  3. Patient will undergo preoperative preparation, which may include dietary restrictions, bowel preparation, and cessation of certain medications.
  4. Patient will undergo the esophagectomy surgery, which may be done through open surgery or minimally invasive techniques.
  5. Patient will spend time in the hospital recovering, which may involve pain management, monitoring for complications, and starting to regain strength and mobility.

After esophagectomy:

  1. Patient will continue to recover in the hospital, gradually increasing mobility and starting to eat and drink again.
  2. Patient may experience symptoms such as difficulty swallowing, reflux, and weight loss.
  3. Patient will be discharged from the hospital and continue the recovery process at home, which may involve follow-up appointments with the surgical team and physical therapy.
  4. Patient may need to make dietary and lifestyle changes to accommodate the changes in their digestive system.
  5. Patient may experience complications such as DGCE, which may require further evaluation and management.
  6. Patient will continue to have long-term follow-up with the surgical team to monitor for any complications or recurrence of the original condition.

What to Ask Your Doctor

Some questions a patient should ask their doctor about esophagectomy and potential complications like Delayed Gastric Conduit Emptying (DGCE) may include:

  1. What is the likelihood of experiencing DGCE after my esophagectomy surgery?
  2. What symptoms should I watch out for that may indicate DGCE?
  3. How is DGCE diagnosed, and what tests or procedures may be involved?
  4. What treatment options are available if I do develop DGCE?
  5. How will DGCE affect my recovery and long-term quality of life?
  6. Are there any preventative measures or lifestyle changes I can take to reduce the risk of DGCE?
  7. How often will I need follow-up appointments to monitor for DGCE or other potential complications?
  8. Are there any specific dietary or activity restrictions I should follow to help prevent DGCE?
  9. What should I do if I experience persistent symptoms that may indicate DGCE?
  10. Are there any support groups or resources available for patients who have undergone esophagectomy and may be dealing with complications like DGCE?

Reference

Authors: Sivakumar J, Chen Q, Duong CP. Journal: Esophagus. 2025 Jul;22(3):289-321. doi: 10.1007/s10388-025-01133-8. Epub 2025 May 28. PMID: 40434573