PD349 - ALTERATIONS IN THE GASTROINTESTINAL MICROBIOTA FOLLOWING PANCREATIC RESECTION: A PROSPECTIVE CASE-CONTROLLED PILOT STUDY

PD349

ALTERATIONS IN THE GASTROINTESTINAL MICROBIOTA FOLLOWING PANCREATIC RESECTION: A PROSPECTIVE CASE-CONTROLLED PILOT STUDY

D. Palmer^1,*, S. Ferrie^1,2, K. Lambert³, C. Sandroussi⁴, S. Carey^1,2

¹Nutrition and Dietetics Department, Royal Prince Alfred Hospital, ²Faculty of Health and Medicine, University of Sydney, Sydney, ³School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, ⁴Department of Upper Gastrointestinal and Hepatobiliary Surgery, Royal Prince Alfred Hospital, Sydney, Australia

Rationale: The long-term impacts of pancreatic resection on the gastrointestinal microbiota are unknown. The aim of this study was to compare the gastrointestinal microbiota profile between post-pancreatoduodenectomy patients and matched healthy controls.

Methods: Patients >6 months post pancreatoduodenectomy surgery were recruited and healthy controls were matched based on age, sex, body mass index (BMI) (kg/m²) and smoking status. A three-day food diary, Gastrointestinal Symptom Rating Scale (GSRS) questionnaire and stool sample were completed by each participant. Comparisons were made between groups using Wilcoxon signed-rank test. Data are reported as median (interquartile range).

Results: Nine matched pairs were recruited including four female pairs and one pair of smokers. Median time post pancreatic resection was 35.0 (28.0 - 49.0) months. The median age of post-surgical patients and healthy controls was 71.0 (61.0 - 76.0) vs 72.0 (63.0 - 77.0) years and BMI 22.5 (21.2 - 24.6) vs 24.1 (22.9 - 26.6) (p = .008), respectively. Post-surgical patients consumed less fibre (20.0 (16.0 - 22.0) vs 25.0 (23.0 - 26.0) grams/day (p = 0.020) and had higher GSRS scores for abdominal symptoms (p = 0.028), diarrhoea (p = 0.027) and overall total gastrointestinal symptoms (p = 0.028). Post-surgical patients had a lower Shannon index (p = .008) and a higher abundance of proteobacteria (p = .028).

Conclusion: Pancreatic resection was associated with a less diverse gastrointestinal microbiota profile, gastrointestinal dysbiosis and worse self-rated gastrointestinal symptoms compared to healthy controls. Larger-scale research is warranted to confirm reproducibility and generalisability of results. Gastrointestinal dysbiosis among this patient group may support future interventional research aimed at modifying the microbiota to improve gastrointestinal symptoms.

Disclosure of Interest: None declared