Surgical approaches to treatment of gastroparesis: gastric electrical stimulation, pyloroplasty, total gastrectomy and enteral feeding tubes.

Irene Sarosiek, Brian Davis, Evelin Eichler, Richard W McCallum

Journal: Gastroenterology clinics of North America 2015;44(1):151-67

PMID: 25667030

Full Text on Elsevier Science View on PubMed

Abstract

Gastric electrical stimulation (GES) is neurostimulation; its mechanism of action is affecting central control of nausea and vomiting and enhancing vagal function. GES is a powerful antiemetic available for patients with refractory symptoms of nausea and vomiting from gastroparesis of idiopathic and diabetic causes. GES is not indicated as a way of reducing abdominal pain in gastroparetic patients. The need for introducing a jejunal feeding tube means intensive medical therapies are failing, and is an indication for the implantation of the GES system, which should always be accompanied by a pyloroplasty to guarantee accelerated gastric emptying.

Address: Division of Gastroenterology, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA.; Department of Surgery, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA.; Division of Gastroenterology, Department of Internal Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, 4800 Alberta Avenue, El Paso, TX 79905, USA. Electronic address: [email protected].

DOI: 10.1016/j.gtc.2014.11.012

Link outs

Subscription / membership required

Full Text Sources:

MeSH Terms: Electric Stimulation Therapy, Enteral Nutrition, Gastrectomy, Gastroparesis, Humans, Jejunostomy, Pylorus, Treatment Outcome