Chronic Gastrointestinal Dysmotility and Pain Following Total Pancreatectomy with Islet Autotransplantation for Chronic Pancreatitis

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

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The prevalence and impact of chronic gastrointestinal dysmotility following total pancreactectomy with islet autotransplantation (TP-IAT) for chronic pancreatitis is not known. Methods: A cross-sectional study of all patients who underwent TP-IAT at our institution from August 2011 to November 2015 was undertaken. The GCSI (Gastroparesis Cardinal Symptom Index), PAGI-SYM (Patient Assessment of Upper Gastrointestinal Disorders-Symptom Severity Index), PAC-SYM (Patient Assessment of Constipation Symptoms), Bristol stool chart, 12-item Short Form Health Survey (SF-12), and visual analog scale for pain were administered ≥4 weeks following TP-IAT. Key Results: The prevalence of any dysmotility symptoms in patients who completed the survey (33/45, 73%) post-TP-IAT was 45%. Post-TP-IAT, the mean reduction in opioid dosing was 77.6 oral morphine equivalents (OMEs) (95% CI 32.1–123.0, p = 0.002) with 42% of patients requiring no opioids. There was significant negative correlation between dysmotility scores and SF-12 physical scores (r = −0.46, p = 0.008, 95% CI −0.70 to −0.13). Self-reported abdominal pain had significant negative correlation with both physical and mental SF-12 scores (r = −0.67, p < 0.001, 95% CI −0.83 to −0.41 and r = −0.39, p = 0.03, 95% CI −0.65 to −0.04). There was no correlation between gastrointestinal dysmotility and self-reported pain. Conclusions and Inferences: Symptoms of chronic gastrointestinal dysmotility and chronic abdominal pain are common post-TP-IAT and will need to be better recognized and differentiated to improve the management of these patients.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Jan 12 2017

Keywords

  • Chronic pancreatitis
  • Post-TP-IAT dysmotility
  • QOL

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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