Abstract: Objective To assess factors influencing the development of DGE after pancreaticoduodenectomy.Methods Cochrane Library,Medline,Ovid and EMBASE databases were searched to identify studies that evaluated the influencing factors in DGE patients and control subjects after pancreaticoduodenectomy.Odds ratios and 95% confidence intervals(CIs)were then calculated by a meta-analysis.Results Six RCTs,twenty case-control and cohort studies met the inclusion criteria.Compared with control subjects,the risk of DGE was 2.35 for preservation of pylorus(95% CI,0.72-7.61),0.93 for postoperative enteral nutrition(95% CI,0.64-1.35),6.14 for postoperative intro-abdominal complications(95% CI,3.47-10.85),4.30 for Billroth I type gastrointestinal reconstruction(95% CI,1.00-18.43),and 0.12 for antecolic gastrointestinal reconstruction(95% CI,0.05-0.27).Conclusions Postoperative intro-abdominal complications were the most important factors associated with DGE.There was no significant association between the DGE and the preservation of pylorus.Postoperative enteral feeding did not show advantages in preventing DGE.Antecolic and Billroth II type gastrointestinal reconstruction seem to suggest an improvement in decreasing the incidence of DGE.