Prevalence and predictors of pain and opioid analgesic use following total pancreatectomy with islet autotransplantation for pancreatitis

Robert A. Moran, Robert Klapheke, George K. John, Sarah Devlin, Daniel Warren, Niraj Desai, Zhaoli Sun, Christi Walsh, Rita R. Kalyani, Erica Hall, Ellen M. Stein, Anthony N. Kalloo, Atif Zaheer, Kenzo Hirose, Martin A. Makary, Vikesh K. Singh

Research output: Contribution to journalArticlepeer-review

Abstract

Background & objectives Total pancreatectomy with islet autotransplantation (TPIAT) is employed for the management of refractory pain in chronic pancreatitis (CP) with the prospect of partial beta cell preservation. The primary aim of this study is to evaluate the prevalence and predictors of abdominal pain and opioid use following TPIAT. Methods A single center cohort study of all adult patients who underwent TPIAT from 2011 to 2015 for CP. Postoperative pain outcomes included: opioid use, ongoing abdominal pain and new characteristic abdominal pain. Multiple logistic regression analysis was used to evaluate known and potential predictors of postoperative pain outcomes. Results During the study period, 46 patients underwent TPIAT. Following surgery, 89% of patients had resolution of their pre-operative abdominal pain; however, 83% of patients developed a new characteristic abdominal pain. Opioid independence was achieved in 46% of patients. Acute recurrent pancreatitis (ARP) (OR: 11.66; 95%CI: 1.47–92.39; p = 0.02) but not pain duration >3 years or ≥ 5 ERCPs was independently associated with resolution of pre-operative abdominal pain on multiple logistic regression. None of these factors were associated with cessation of opioid use. Conclusion While the majority of patients have resolution of their initial abdominal pain following TPIAT, many will also develop a new characteristic abdominal pain and only half of all patients achieve opioid independence. ARP is the only independent factor associated with positive postoperative pain outcomes and should be considered a standard criterion for patient selection.

Original languageEnglish (US)
Pages (from-to)732-737
Number of pages6
JournalPancreatology
Volume17
Issue number5
DOIs
StatePublished - Sep 2017

Keywords

  • Chronic pancreatitis
  • Opioid analgesics
  • Pain
  • Surgery
  • TPIAT

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Hepatology
  • Gastroenterology

Fingerprint Dive into the research topics of 'Prevalence and predictors of pain and opioid analgesic use following total pancreatectomy with islet autotransplantation for pancreatitis'. Together they form a unique fingerprint.

Cite this