BACKGROUND: The prevalence and factors associated with delayed gastric emptying (DGE) in patients undergoing total pancreatectomy with islet auto transplantation (TP-IAT) for chronic pancreatitis are unknown. METHODS: A retrospective study of all patients who underwent TP-IAT at Johns Hopkins Hospital (JHH) from August 2011 to November 2014 was performed. The International Study Group of Pancreatic Surgery (ISGPS) clinical grading of DGE was used in this study. KEY RESULTS: A total of 39 patients with chronic pancreatitis underwent TP-IAT during the study period. The prevalence of DGE following TP-IAT was 35.9%. Twenty-five patients (64.1%) had no DGE, 10 (25.6%) had grade A, 2 (5.1%) had grade B, and 2 patients (5.1%) had grade C DGE. Patients with DGE had 5.7-fold higher odds of having a hospital length of stay (LOS) greater than 14 days (OR 5.70, 95% CI 1.37-23.76, p = 0.02). Patients undergoing laparoscopic TP-IAT had significantly shorter LOS (10.5 vs. 14 days, p = 0.02) and lower need for prokinetics (0.01) during the postoperative course. CONCLUSIONS AND INFERENCES: DGE is common after TP-IAT and can prolong LOS. Laparoscopic TP-IAT lowers LOS and need for prokinetics postoperatively. Further studies are needed to determine if laparoscopic approaches will improve long-term dysmotility.
BACKGROUND: The prevalence and factors associated with delayed gastric emptying (DGE) in patients undergoing total pancreatectomy with islet auto transplantation (TP-IAT) for chronic pancreatitis are unknown. METHODS: A retrospective study of all patients who underwent TP-IAT at Johns Hopkins Hospital (JHH) from August 2011 to November 2014 was performed. The International Study Group of Pancreatic Surgery (ISGPS) clinical grading of DGE was used in this study. KEY RESULTS: A total of 39 patients with chronic pancreatitis underwent TP-IAT during the study period. The prevalence of DGE following TP-IAT was 35.9%. Twenty-five patients (64.1%) had no DGE, 10 (25.6%) had grade A, 2 (5.1%) had grade B, and 2 patients (5.1%) had grade C DGE. Patients with DGE had 5.7-fold higher odds of having a hospital length of stay (LOS) greater than 14 days (OR 5.70, 95% CI 1.37-23.76, p = 0.02). Patients undergoing laparoscopic TP-IAT had significantly shorter LOS (10.5 vs. 14 days, p = 0.02) and lower need for prokinetics (0.01) during the postoperative course. CONCLUSIONS AND INFERENCES: DGE is common after TP-IAT and can prolong LOS. Laparoscopic TP-IAT lowers LOS and need for prokinetics postoperatively. Further studies are needed to determine if laparoscopic approaches will improve long-term dysmotility.
Authors: Kris P Croome; Michael B Farnell; Florencia G Que; K Marie Reid-Lombardo; Mark J Truty; David M Nagorney; Michael L Kendrick Journal: J Gastrointest Surg Date: 2014-10-02 Impact factor: 3.452
Authors: Dong K Kim; Alexander A Hindenburg; Sushil K Sharma; Chang Ho Suk; Frank G Gress; Harry Staszewski; James H Grendell; William P Reed Journal: Ann Surg Oncol Date: 2005-03-03 Impact factor: 5.344
Authors: George K John; Vikesh K Singh; Robert A Moran; Daniel Warren; Zhaoli Sun; Niraj Desai; Christi Walsh; Rita R Kalyani; Erica Hall; Kenzo Hirose; Martin A Makary; Ellen M Stein Journal: J Gastrointest Surg Date: 2017-01-12 Impact factor: 3.452
Authors: Jaimie D Nathan; Yi Yang; Anne Eaton; Piotr Witkowski; Martin Wijkstrom; Matthew Walsh; Guru Trikudanathan; Vikesh K Singh; Sarah J Schwarzenberg; Timothy L Pruett; Andrew Posselt; Bashoo Naziruddin; Sri Prakash Mokshagundam; Katherine Morgan; Luis F Lara; Varvara Kirchner; Jin He; Timothy B Gardner; Martin L Freeman; Kate Ellery; Darwin L Conwell; Srinath Chinnakotla; Gregory J Beilman; Syed Ahmad; Maisam Abu-El-Haija; James S Hodges; Melena D Bellin Journal: Pancreatology Date: 2021-09-29 Impact factor: 3.996
Authors: Varvara A Kirchner; Ty B Dunn; Gregory J Beilman; Srinath Chinnakotla; Timothy L Pruett; Joshua J Wilhelm; Sarah J Schwarzenberg; Martin L Freeman; Melena D Bellin Journal: Curr Treat Options Gastroenterol Date: 2017-12