目前，对于胰腺导管腺癌（PDAC）患者胰十二指肠切除术（PD）后胃排空延迟（DGE）仍缺乏准确的预测模型。本研究的目的是开发一个能够有效预测 DGE 风险的简明模型。这项回顾性队列研究包括来自美国多中心 ACS-NSQIP 数据库的 1251 名连续接受 PD 治疗的 PDAC 患者的训练队列。此外，还纳入了来自中国国家癌症中心的 934 名连续接受 PD 治疗的 PDAC 患者的验证队列。共有 46 项围手术期指标纳入分析。然后使用 Lasso-logistic 回归开发并验证了 DGE 风险分层 (DGERS) 模型。使用 Lasso-logistic 回归进行筛选后，我们确定了与 DGE 显着相关的四个独立预测因子：胰腺引流管切除天数（HR，1.05；95） % CI，1.02-1.08；p < 0.001）、胰瘘（HR，2.61；95% CI，1.65-4.12；p < 0.001）、脓毒症/感染性休克（HR，2.46；95% CI，1.52-3.91；p < 0.001）和再次手术（HR，4.16；95% CI，2.27-7.57；p < 0.001）。基于这些因素，我们开发了列线图来预测术后 DGE。该模型在验证队列中表现出出色的校准和最佳性能（AUC，0.73；95% CI，0.67-0.73）。在验证队列中，DGERS 表现出显着的风险分层能力，低、中、高风险组的 AUC 值分别为 0.7、0.61 和 0.74。本研究确定了独立增加 DG 发生率的四个因素。 PD 后 PDAC 患者的 DGE，包括胰引流管拔除、胰瘘、脓毒症/感染性休克和再次手术前的天数。基于这些发现，我们开发了一种个性化且简单的 DGERS，能够动态、精确地预测 DGE 风险，从而根据个人的风险状况对个人进行有效分层。© 2024 作者。 《联合欧洲胃肠病学杂志》由 Wiley periodicals LLC 代表联合欧洲胃肠病学出版。

Currently, there is still a lack of an accurate predictive model for delayed gastric emptying (DGE) following pancreaticoduodenectomy (PD) in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to develop a concise model that could effectively predict the risk of DGE.This retrospective cohort study included a training cohort of 1251 consecutive PDAC patients who underwent PD from the US multicenter ACS-NSQIP database. Additionally, a validation cohort of 934 consecutive PDAC patients who underwent PD was included from the National Cancer Center in China. A total of 46 perioperative indicators were incorporated in the analysis. The DGE risk stratification (DGERS) model was then developed and validated using Lasso-logistic regression.After screening using Lasso-logistic regression, we identified four independent predictors that were significantly correlated with DGE: days to pancreatic drain removal (HR, 1.05; 95% CI, 1.02-1.08; p < 0.001), pancreatic fistula (HR, 2.61; 95% CI, 1.65-4.12; p < 0.001), sepsis/septic shock (HR, 2.46; 95% CI, 1.52-3.91; p < 0.001), and reoperation (HR, 4.16; 95% CI, 2.27-7.57; p < 0.001). Based on these factors, we developed a nomogram to predict postoperative DGE. The model demonstrated excellent calibration and optimal performance in the validation cohorts (AUC, 0.73; 95% CI, 0.67-0.73). In the validation cohort, the DGERS exhibited significant risk stratification ability, with AUC values of 0.7, 0.61, and 0.74 for the low-, moderate-, and high-risk groups, respectively.This study identified four factors that independently increased the occurrence of DGE in patients with PDAC after PD, including days to pancreatic drain removal, pancreatic fistula, sepsis/septic shock, and reoperation. Based on these findings, we developed a personalized and straightforward DGERS that enables dynamic and precise prediction of DGE risk, allowing for effective stratification of individuals based on their risk profiles.© 2024 The Author(s). United European Gastroenterology Journal published by Wiley Periodicals LLC on behalf of United European Gastroenterology.