C0275 - Comparison of Surgical Interventions in Patients With Gastroparesis and Functional Dyspepsia

Gengqing Song, MD¹, Yuhan Fu, DO¹, Yan Sun, MD^2
1MetroHealth Medical Center/Case Western Reserve University, Cleveland, OH; ²Summa Health Medical Group, Stow, OH

Introduction: Gastroparesis (GP) and functional dyspepsia (FD) present with overlapping symptoms differentiated by delayed gastric emptying in GP. Postsurgical GP is the third leading etiology for GP. Surgical history is not commonly considered to be a risk factor for FD. A lot of patients received cholecystectomy for abdominal pain without clear indications. The goal of the study was to compare if there was any difference of surgical interventions in patients with GP and FD.

Methods: We performed a retrospective analysis using IBM Explorys (1999-2022). Patient populations were identified using SNOMED. We selected patients who have completed a gastric emptying study and divided them into GP and FD cohort. GP cohort included patients with gastroparesis with the exclusion criteria of cyclical vomiting syndrome, psychoactive substance abuse, eating disorder, factitious disorder, malignant tumor of esophagus and stomach, neoplasm of abdomen, gastric or intestinal obstruction, IBD, adhesion of intestine, carcinomatosis, perforation of intestine, Roux-en-Y gastrojejunostomy, and gastrectomy. FD cohort was similarly constructed with additional exclusion criteria: gastroparesis, gastrointestinal ulcer, brain neoplasm and pancreatitis. Surgical history and its timeline were collected, including fundoplication, cholecystectomy, and para-esophageal hernia repair. To select the patients who did not have a clear indication for cholecystectomy, we excluded cholangitis, cholecystitis, gallbladder polyp and neoplasm, obstruction of biliary tree, and injury of gallbladder. Number of patient and percentage were obtained. Odds Ratios (OR) with 95% confidence interval were calculated.

Results: We identified a total of 17570 patients with GP and 60230 patients with FD. A significant percentage of patients with GP received cholecystectomy, which was higher than that of FD (26.9 vs 17.9%, p< 0.001). There were a higher percentage of fundoplication and paraoesophageal hernia repair in GP than FD (1.99 vs 1.69%, p=0.0082; 0.80 vs 0.53%, p=0.0001). A total of 3720 (79%) of patients with GP and 8360 (77%) of patients with FD received cholecystectomy without a clear indication. Interestingly, for patients with GP who underwent cholecystectomy, the diagnosis of GP was made after cholecystectomy in 30.2% of the cases.

Discussion: Patients with GP are more likely to receive surgical intervention than FD, especially cholecystectomy. Over three quarters of patients with GP and FD receive cholecystectomy without a clear indication.



Disclosures:


Gengqing Song, MD¹, Yuhan Fu, DO¹, Yan Sun, MD². C0275 - Comparison of Surgical Interventions in Patients With Gastroparesis and Functional Dyspepsia, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.