Endoscopic and Surgical Treatments for Gastroparesis: What to Do and Whom to Treat?

Abstract

Gastroparesis is a complex chronic debilitating condition of gastric motility resulting in the delayed gastric emptying and multiple severe symptoms, which may lead to malnutrition and dehydration. Initial management of patients with gastroparesis focuses on the diet, lifestyle modification and medical therapy. Various endoscopic and surgical interventions are reserved for refractory cases of gastroparesis, not responding to conservative therapy. Pyloric interventions, enteral access tubes, gastric electrical stimulator and gastrectomy have been described in the care of patients with gastroparesis. In this article, the authors review current management, indications, and contraindications to these procedures.

Keywords: Gastric electrical stimulator; Gastric pacemaker; Gastric peroral endoscopic myotomy (GPOEM); Gastroparesis; Peroral pyloromyotomy (POP); Pyloromyotomy; Pyloroplasty.