EndoFLIP and Pyloric Dilation for Gastroparesis Symptoms Refractory to Pyloromyotomy/Pyloroplasty

Background Gastroparesis patients may undergo pyloromyotomy/pyloroplasty for chronic refractory symptoms. However, some patients have persistent symptoms. It is unknown if balloon dilation may improve their symptoms. Aims We aimed to (1) assess if pyloric through-the-scope (TTS) balloon dilation res...

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Bibliographic Details
Published in:Digestive diseases and sciences 2021-08, Vol.66 (8), p.2682-2690
Main Authors: Jehangir, Asad, Malik, Zubair, Petrov, Roman V., Parkman, Henry P.
Format: Article
Language:English
Subjects:
Biochemistry
Endoscopy
Gastroenterology
Hepatology
Medical colleges
Medicine
Medicine & Public Health
Nausea
Oncology
Original Article
Patients
Questionnaires
Stomach
Thoracic surgery
Transplant Surgery
Vomiting
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Summary:Background Gastroparesis patients may undergo pyloromyotomy/pyloroplasty for chronic refractory symptoms. However, some patients have persistent symptoms. It is unknown if balloon dilation may improve their symptoms. Aims We aimed to (1) assess if pyloric through-the-scope (TTS) balloon dilation results in symptom improvement in gastroparesis patients with suboptimal response to pyloromyotomy/pyloroplasty and (2) determine endoscopic functional luminal imaging probe (EndoFLIP) characteristics of these patients before dilation. Methods Patients with severe gastroparesis refractory to pyloromyotomy/pyloroplasty seen from 2/2019 to 3/2020 underwent pyloric TTS dilation after assessing the pyloric characteristics using EndoFLIP. Patients completed Gastroparesis Cardinal Symptom Index (GCSI) pre-procedurally, and GCSI and Clinical Patient Grading Assessment Scale (CPGAS) on follow-ups. Results Thirteen (ten females) patients (mean age 45.2 ± 5.1 years) with severe gastroparesis symptoms (mean GCSI total score 3.4 ± 0.3) after pyloromyotomy/pyloroplasty underwent pyloric TTS dilation. Overall, there was improvement in symptoms at 1-month follow-up (mean GCSI total score 3.0 ± 0.4, mean CPGAS score 1.6 ± 0.5, p  
ISSN:0163-2116
1573-2568
DOI:10.1007/s10620-020-06510-0