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J Gastrointest Surg (2017) 21:222227 DOI 10.1007/s11605-016-3327-4
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Web End = 2016 SSAT QUICK SHOT PRESENTATION
The Long-Term Efficacy and Safety of Pyloroplasty Combined with Gastric Electrical Stimulation Therapy in Gastroparesis
Brian R. Davis1 & Irene Sarosiek2 & Mohammad Bashashati2 & Ben Alvarado2 &
Richard W. McCallum2
Received: 27 May 2016 /Accepted: 15 November 2016 /Published online: 28 November 2016 # 2016 The Society for Surgery of the Alimentary Tract
AbstractIntroduction Gastroparesis is delayed gastric emptying without mechanical obstruction. Symptomatic improvement can be 5060% with gastric electrical stimulation. To address delayed gastric emptying, pyloroplasty was added. This study examines the long-term efficacy and safety of simultaneous gastric electrical stimulator implantation and pyloroplasty.
Methods In this prospective single-arm trial conducted from 2012 to 2015, 27 [23 females; mean age 43 (2263)] gastroparesis patients who underwent simultaneous gastric electrical stimulator implantation with Heineke-Mikulicz pyloroplasty were studied. Six (25%) underwent simultaneous robot-assisted pyloroplasty and gastric electrical stimulator implantation. Diagnosis of gastroparesis was based on the 4-h gastric emptying test defined as >60% retention of isotope at 2 h and >10% at 4 h. Total symptom scores assessing severity of nausea, early satiety, bloating, vomiting, post-prandial fullness, and epigastric pain were obtained at baseline and at follow-up visits, ranging from 3 to 38 months (mean: 17).
Results Follow-up data from 24 patients were available for analysis. There was 71% improvement in total symptom score on follow-up. Mean retention decreased by 29.6 and 48.7% at 2 and 4 h and gastric emptying was normalized in 60%. There were no post-surgical complications.
Conclusions Combination of gastric electrical stimulator and pyloroplasty significantly accelerated gastric emptying and improved gastroparesis symptoms. Combining these two surgical therapies improves both subjective and objective endpoints in drug refractory gastroparesis.
Keywords Neurostimulator . Gastroparesis . Pyloroplasty .
Gastric emptying . Enterra
Presented at Digestive Disease Week, May 22, 2016
* Brian R. Davis [email protected]
1 Department of Surgery, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave, El Paso, TX 79905, USA
2 Department of Internal Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave, El Paso, TX 79905, USA
Introduction
Gastroparesis (GP) affects 24% of the population in the USA.1 As the primary diagnosis...