ArticleSurgical endoscopy2015
Surgical treatment of medically refractory gastroparesis in the morbidly obese.
Article in Surgical endoscopy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 34 citations in OpenAlex.
- Roux-en-Y Gastric Bypass and Sleeve Gastrectomy Risk-Adjusted Safety Profiles after Previous Fundoplication: A 499-Patient MBSAQIP Analysis.Obesity surgery · 2026Article
- Reconsideration of the Gastroparetic Syndrome.Current gastroenterology reports · 2023Review
- Maintenance of a Gastric Pacemaker in the Excluded Stomach During a Roux-en-Y Gastric Bypass Procedure in a Patient with Obesity, Type 1 Diabetes and Refractory Gastroparesis.Obesity surgery · 2021Article
- Pathophysiology, Aetiology and Treatment of Gastroparesis.Digestive diseases and sciences · 2020Review
- Gastrectomy versus stomach left in situ with Roux-en-Y reconstruction for the treatment of gastroparesis.Surgical endoscopy · 2020Article
- Gastric Electric Stimulation for Refractory Gastroparesis.Journal of clinical outcomes management : JCOM · 2019Article
- Liraglutide Effects on Upper Gastrointestinal Investigations: Implications Prior to Bariatric Surgery.Obesity surgery · 2018Article
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Authors and funding
9 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSurgical management of medically refractory gastroparesis remains a challenge. Case series and small retrospective studies describe clinical benefits from surgical intervention; however, no study reports the efficacy of gastric electrical stimulation (GES) or Roux-en-Y gastrojejunostomy with or without near-total gastrectomy (RYGJ) in morbidly obese patients with severe gastroparesis.
methodsA chart review was performed on all morbidly obese patients (BMI > 35 kg/m(2)) who underwent GES or RYGJ for medically refractory gastroparesis from March 2002 to December 2012 at the Cleveland Clinic. The main outcomes examined were symptom improvement, postoperative complications, and change in BMI.
resultsA total of 20 morbidly obese patients underwent GES placement. Seven morbidly obese patients had RYGJ with or without resection of the remnant stomach surgery. All operations were completed laparoscopically. In GES group, 18 patients had initial symptom improvement (90%) and 11 (55%) rated their symptom improved at the last follow-up. During the average 23 months' follow-up, 9 patients (45%) experienced at least one readmission for gastrointestinal reasons. Early complications included two infections at a simultaneously placed J-tube site and one seroma. In the RYGJ group, all patients, including 4 patients who failed GES and subsequently converted to RYGJ, experienced short-term symptom improvement and 5 patients (71%) rated their symptoms as improved at last follow-up. One duodenal stump leak happened in the RYGJ group. There were no 30-day mortalities in either group. The BMI change after GES implantation was 0.6 ± 4 kg/m(2) versus -7.7 ± 4 kg/m(2) after RYGJ (p < 0.01).
conclusionGES implantation and RYGJ are both effective in terms of symptom control for medically refractory gastroparesis in morbidly obese. Both options can be performed in a minimally invasive fashion with low morbidity. Patients who have no improvement of symptoms for refractory gastroparesis after GES implantation can be successfully converted laparoscopically to RYGJ.
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