Intraoperative Pyloric Botulinum Toxin Injection for Post Total Pancreatectomy With Islet Autotransplantation Gastroparesis Improvement in Children

jpedsurg.org

Acute Recurrent Pancreatitis (ARP) and Chronic Pancreatitis (CP) may cause abdominal pain, malnutrition, opioid dependency, and impairment in quality of life. Total Pancreatectomy with Islet Autotransplantation (TPIAT) is an option when other measures fail. Pancreatitis gastroparesis can be potentiated by surgery. Botulinum toxin (BT) injections into the pylorus have been used in children for gastroparesis. We evaluated outcomes of pyloric injection of BT for TPIAT in children.

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Article · Apr 2025 · 1 min read

In brief

This study examines intraoperative botulinum toxin injection into the pylorus to prevent or treat gastroparesis in pediatric patients undergoing total pancreatectomy with islet autotransplantation (TPIAT) for chronic or acute recurrent pancreatitis. The intervention addresses a common postoperative complication that can significantly impact recovery and quality of life in children.

TPIAT is a surgical option for refractory ARP/CP causing pain, malnutrition, and opioid dependency in children.
Post-TPIAT gastroparesis is a recognized complication that can worsen existing pancreatitis-related gastric dysmotility.
Intraoperative pyloric botulinum toxin injection may prevent or reduce gastroparesis severity after TPIAT in pediatric patients.
Botulinum toxin works by relaxing the pyloric sphincter, facilitating gastric emptying in gastroparesis cases.
This approach represents a proactive strategy to address a known post-operative complication during the index procedure.

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