Abstract

INTRODUCTION: Post-operative delayed gastric emptying (DGE) is a frustrating complication of pancreaticoduodenectomy (PD). We studied whether monitoring of post-operative gastric motor activity using a novel wireless patch system can identify patients at risk for DGE.METHODS: Eighty-one patients were prospectively studied since 2016; 75 patients were analyzed for this study. After PD, battery-operated wireless patches (G-Tech Medical) that acquire gastrointestinal myoelectrical signals are placed on the abdomen and transmit data by Bluetooth. Patients were divided into EARLY and LATE groups, by diet tolerance of 7 days (ERAS goal). Subgroup analysis was done of patients included after ERAS initiation.RESULTS: The EARLY and LATE groups had 50 and 25 patients, respectively, with length of stay (LOS) 7 and 11 days (p<0.05). Nasogastric insertion was required in 44% of the LATE group. Tolerance of food was noted by 6 vs 9 days in the EARLY vs LATE group (p<0.05) with higher cumulative gastric myoelectrical activity. Diminished gastric myoelectrical activity accurately identified delayed tolerance to regular diet in a logistical regression analysis (area under the curve (AUC), 0.81; 95% CI, 0.74-0.92). The gastric myoelectrical activity also identified delayed LOS status with an AUC of 0.75 (95% CI, 0.67-0.88). Stomach signal continued to be predictive in 90% of the ERAS cohort despite earlier oral intake.CONCLUSIONS: Measurement of gastric activity after PD can distinguish patients with shorter or longer times to diet. This non-invasive technology provides data to identify patients at risk for DGE and may guide timing of oral intake by gastric "readiness."

View details for PubMedID 30048596