Back to Annual Meeting Program

Introduction: In recent publications, Alvimopan has been shown to improve gastrointestinal recovery in patients who are undergoing bowel resections. We intend to see if patients undergoing Pancreaticoduodenectomies, a major surgical resection, and who were administered Alvimopan demonstrate a significant improvement in bowel movement recovery, first intake of clear liquid diet, and first intake of soft/solid food diet; compared to patients not administered with Alvimopan.
Methods: From a retrospective review of 255 pancreaticoduodenectomy patients under a single surgeon between years 2005-2011, 23 patients in 2011 were given Alvimopan. After excluding patients who received narcotics within 7 days before their surgery and after excluding Whipple-pylorus preserving, 15 Whipple-standard patients were left to analyze. For every one patient who was given Alvimopan, we found 2 patients who shared similar age, BMI, and pathology diagnosis and same Co-Morbidity and pT stage. We collected 30 patients ranging from years (2005-2011) who met these criteria, were not given Alvimopan, and who underwent a Whipple-standard procedure. We also excluded patients who received narcotics within 7 days before their surgery in this group. All Alvimopan patients received their first dose immediately preoperatively.
Results: When comparing the two groups, significance was noted for the mean length of hospital stay (P=0.0483), mean time to first clear liquid diet (P=0.00212), and mean time to first soft/solid food diet (P=0.0406). There was no significant difference noted between age, BMI, Co-morbidity, and mean time to first bowel movement (see Table 1).
Conclusion: With a comparison between the Alvimopan and non-Alvimopan group, we recognize a significant decrease in the length of hospital stay with a possible cost benefit, due to a significantly earlier intake of diet in the Alvimopan’s group. We believe with a radical procedure, such as pancreaticoduodenectomy, Alvimopan results in earlier recovery.

Table 1 Patients Treated with Alvimopan and No Alvimopan

	Alvimopan	No Alvimopan	P value
Number of Patients	15	30
Mean Age	67.6	65.3	P=0.430 [NS]
Mean BMI	25.4	24.9	P=0.738 [NS]
Mean Co Morbidity	2.53	2.53	P=1.00 [NS]
Mean Length of Hospital Stay (days)	12	14.6	P=0.0483 [S]
Meant Time to 1st Bowel Movement (days)	6	6.77	P=0.148 [NS]
Mean Time to 1st Clear Liquid Diet (days)	6	7.63	P=0.00212 [S]
Mean Time to 1st soft/solid food diet (days)	8.67	9.9	P=0.0406 [S]

*[S] Significant *[NS] Not Significant