Sean Harbison

Association of low numbers of CD206-positive cells with loss of ICC in the gastric body of patients with diabetic gastroparesis

There is increasing evidence for specific cellular changes in the stomach of patients with diabetic (DG) and idiopathic (IG) gastroparesis. The most significant findings are loss of interstitial cells of Cajal (ICC), neuronal abnormalities, and an immune cellular infiltrate. Studies done in diabetic mice have shown a cytoprotective effect of CD206+ M2 macrophages. To quantify overall immune cellular infiltrate, identify macrophage populations, and quantify CD206+ and iNOS+ cells. To investigate associations between cellular phenotypes and ICC.

The GI Surgeon and Gastroparesis

Gastroparesis is a complex chronic disorder of delayed gastric emptying with a variety of etiologic factors. Treatment of gastroparesis is primarily medical and optimally provided by an experienced gastroenterologist. The role of surgical intervention for patients with gastroparesis is not well defined with little evidence-based data. Some severely refractory patients may undergo surgical procedures for several reasons, including nutritional support, gastric stimulation, or rarely, definitive surgical treatment. The complexity of the disease makes it a challenge to define the role of surgical intervention in a way that provides benefit for patients while minimizing the risk. This manuscript reviews the current indications and options for surgical interventions, supportive and definitive, available for patients with gastroparesis.

1087 Gastric Interstitial Cells of Cajal Quantification on Full Thickness Gastric Biopsy Provides Prognostic Information for Treatment Responses to Gastric Electric Stimulation

and SMW total scores remained when analysis was limited to normal or delayed gastric emptying (p<0.05, p<0.05). Only 13% (3/24) needed tube feeds and 13% (3/24) parenteral nutrition after GES. School absences decreased from 57% to 31% of school days. Overall, 65% (13/20) reported their health was much improved after GES versus 15% (3/20) the same or worse. The majority (15/20) were satisfied with GES. Three were not satisfied due to lack of improvement, one developed back pain and another was later diagnosed with an eating disorder. Five reported complications. Four had discomfort or tenderness at the implantation site and another had a dead battery. Conclusions: In the largest series to date of pediatric patients who have undergone GES for GP and/or FD, we have found significant and sustained improvement not only in upper GI symptoms but also in quality of life and perception of global health. Patients were less dependent on tube feeding or parenteral nutrition and had fewer school absences. The majority is satisfied with the decision to place GES. Future studies are needed to assess for possible placebo effect and to evaluate predictors of outcome and long-term prognosis.