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Safety and efficacy of endoscopic pyloric dilation in gastroparesis patients

refractory_gastroparesis refractory_gastroparesis
refractory_gastroparesis refractory_gastroparesis

The study aimed to examine the efficacy and safety of endoscopic pyloric dilation in gastroparesis patients, confirmed by gastric emptying scintigraphy.

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Key take away

Endoscopic pyloric balloon dilation is an effective treatment and results in sustained improvement in people suffering from refractory gastroparesis.

Background

The study aimed to examine the efficacy and safety of endoscopic pyloric dilation in gastroparesis patients, confirmed by gastric emptying scintigraphy.

Method

In this retrospective analysis, participants (n=47) suffering from refractory gastroparesis were recruited and treated with endoscopic pyloric dilation. The efficacy of the technique estimated at 2 and 6 months with the Gastric Cardinal Symptom Index (GCSI) was the major endpoint ascertained.

Result

At 2 months, 53% of patients (n=25) and at 6 months, 40% of patients (n=19) exhibited a clinical response that was defined by a 1.0 point reduction in GCSI score. Compared to the preoperative score, a substantial reduction in GCSI score at 2 and 6 months was observed. No complications were reported. At 1 year, 9 participants had a delayed relapse.

As found, a second dilation was carried out for 8 participants and was found to be effective in 5 participants. Notably, 27.0 ± 10.4 months was the mean follow-up time of the volunteers. Following this treatment, 15 participants (32%) still experienced betterment. There was no predictive factor of clinical response.

Conclusion

In refractory gastroparesis patients, the efficacy of pyloric dilation was 53% at 2 months, with sustained improvement in one-third of patients at two years. Thus, endoscopic pyloric balloon dilation can be deemed as a substitute for pyloromyotomy.

Source:

Surgical Endoscopy

Article:

Efficacy and safety of endoscopic pyloric balloon dilation in patients with refractory gastroparesis

Authors:

Heithem Soliman et al.

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