title: Delayed Gastric Emptying (DGE) Following Total Pancreatectomy with Islet Auto Transplantation in Patients with Chronic Pancreatitis.
abstract: 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.
  
  
  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
  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.affiliation: Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, 1830 East Monument St, Suite 429, Baltimore, MD, 21287, USA.
authors.forename: George K
authors.initials: GK
authors.lastname: John
authors.forename: Vikesh K
authors.initials: VK
authors.lastname: Singh
authors.forename: Pankaj J
authors.initials: PJ
authors.lastname: Pasricha
authors.forename: Amitasha
authors.initials: A
authors.lastname: Sinha
authors.forename: Elham
authors.initials: E
authors.lastname: Afghani
authors.forename: Daniel
authors.initials: D
authors.lastname: Warren
authors.forename: Zhaoli
authors.initials: Z
authors.lastname: Sun
authors.forename: Niraj
authors.initials: N
authors.lastname: Desai
authors.forename: Christi
authors.initials: C
authors.lastname: Walsh
authors.forename: Rita R
authors.initials: RR
authors.lastname: Kalyani
authors.forename: Erica
authors.initials: E
authors.lastname: Hall
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hirose
authors.forename: Martin A
authors.initials: MA
authors.lastname: Makary
authors.forename: Ellen M
authors.initials: EM
authors.lastname: Stein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D018589:Gastroparesis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D016381:Islets of Langerhans Transplantation / Q000009:adverse effects* / Q000379:methods; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects* / Q000379:methods; D050500:Pancreatitis, Chronic / Q000601:surgery*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014182:Transplantation, Autologous; D016896:Treatment Outcome; D055815:Young Adult