Abstract
Management of refractory gastroparesis is challenging after diet, prokinetics, and
long-term nutritional support have failed. In this review, the efficacy and safety
of surgical interventions (sleeve gastrectomy and Roux-en-Y gastric bypass surgery)
are evaluated systematically in patients with refractory gastroparesis. The PubMed,
Embase, and Scopus databases were searched to identify relevant studies published
up to June 2021. Outcome of interest was symptom improvement and gastric emptying.
Nineteen studies with 222 refractory gastroparesis patients (147 Roux-en-Y gastric
bypass, 39 sleeve gastrectomy, and 36 subtotal gastrectomy) were included. All studies
reported symptom improvement postoperatively, particularly vomiting and nausea. Gastric
emptying improved postoperatively in 45% up to 67% for sleeve gastrectomy and 87%
for Roux-en-Y gastric bypass. The findings of our systematic review suggest that sleeve
gastrectomy and Roux-en-Y gastric bypass surgery improve symptoms and gastric emptying
in patients with refractory gastroparesis. Surgery may be effective as treatment for
a small group of patients when all other therapies have failed.
Keywords
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Article info
Publication history
Published online: September 16, 2022
Accepted:
September 12,
2022
Received:
June 6,
2022
Identification
Copyright
© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- Comment on: Systematic review on sleeve gastrectomy or Roux-en-Y gastric bypass surgery for refractory gastroparesisSurgery for Obesity and Related DiseasesVol. 19Issue 3
- PreviewThis is a systematic review of the utility of sleeve gastrectomy (SG) or Roux-en-Y gastric bypass (RYGB) for patients with refractory gastroparesis (GSP) [1]. GSP is oftentimes difficult to manage after attempts at medical management and a multitude of options have been proposed. The aim of the study was to assess the efficacy of the most common bariatric surgeries performed on symptom improvement and gastric emptying. From a title and abstract screen of 2102 articles and full-text assessments of 75 articles, 19 total studies were selected for review.
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