HPB : the official journal of the International Hepato Pancreato Biliary Association · 2025
Long-term evaluation of gastric electrophysiology, symptoms and quality of life after pancreaticoduodenectomy.
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Wang Tim Hsu-Han, Varghese Chris, Calder Stefan, Gharibans Armen, Schamberg Gabriel, Bartlett Adam, Srinivasa Sanket, O'Grady Greg
Аннотация
BACKGROUND: Pancreaticoduodenectomy (PD) is typically performed for pancreatic and biliary malignancies. Post-operative gastric dysfunction is common and the underlying pathophysiology is still poorly understood. This study aimed to evaluate the gastric electrophysiology, symptoms and quality of life (QoL) following PD, using the novel non-invasive Gastric Alimetry mapping system.
METHODS: PD patients from Auckland between 2017 and 2022 were recruited. Gastric Alimetry® (Alimetry, New Zealand) was employed, comprising a stretchable wearable array (8×8 electrodes) and a validated app for symptom logging. A 30-min pre-prandial and a 4-hour post-prandial recording was performed. Data collected includes Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index, meal response, symptoms and QoL questionnaires (PAGI-QOL, EQ-5D-5L). Data was compared to matched healthy controls. Pearson's correlation analysis was performed.
RESULTS: 19 patients and 19 healthy controls were recruited. Moderate to severe symptoms and QoL were found in 8/19 (42 %) and at least one abnormal electrophysiology parameter in 8/19 (42 %), albeit uncorrelated (p=0.43). Significant differences were found in PAGI-QOL and EQ-5D-5L with controls (p<0.01).
CONCLUSION: Moderate to severe upper GI symptoms are common after PD. Although altered gastric electrophysiology is common, other factors are likely more relevant to long-term QoL. Notably, short term associations remain uninvestigated.
METHODS: PD patients from Auckland between 2017 and 2022 were recruited. Gastric Alimetry® (Alimetry, New Zealand) was employed, comprising a stretchable wearable array (8×8 electrodes) and a validated app for symptom logging. A 30-min pre-prandial and a 4-hour post-prandial recording was performed. Data collected includes Principal Gastric Frequency, BMI-adjusted amplitude, Gastric Alimetry Rhythm Index, meal response, symptoms and QoL questionnaires (PAGI-QOL, EQ-5D-5L). Data was compared to matched healthy controls. Pearson's correlation analysis was performed.
RESULTS: 19 patients and 19 healthy controls were recruited. Moderate to severe symptoms and QoL were found in 8/19 (42 %) and at least one abnormal electrophysiology parameter in 8/19 (42 %), albeit uncorrelated (p=0.43). Significant differences were found in PAGI-QOL and EQ-5D-5L with controls (p<0.01).
CONCLUSION: Moderate to severe upper GI symptoms are common after PD. Although altered gastric electrophysiology is common, other factors are likely more relevant to long-term QoL. Notably, short term associations remain uninvestigated.