Gastric Electrical Stimulator and Its Impact on Symptom Reduction in Gastroparesis Patients With Prior Cholecystectomy

in GP of diabetic (DM), idiopathic (ID), and postvagotomy (P-V) etiologies; 2) Assess the correlation of changes in gastric emptying in GES patients after PP with improvement of GP symptoms.Methods A total of 33 (13 DM, 7 ID, 13 P-V) consecutive GP patients [25F; mean age 43 (20-73 years); mean weight 148 lbs (86-245); mean duration of GP 4 years (1-10)] underwent GES implantation, and additionally all of them have received the Heineke-Mikulicz PP.Total GP symptoms scores (TSS) assessing severity (S) and frequency (F) of nausea (N), early satiety (ES), bloating (B), vomiting (V), postprandial fullness (PF), epigastric pain (EP), and burning (EB) were obtained by using a 5-point Likert scale (max 28 points) at baseline and at last follow up visit, ranging from 3 to 18 months with mean 6 month.The 4-hrs scintigraphy method of GET was conducted before surgery and at F/U visits where GP was defined as > 60% retention of isotope at 2 hrs and >10% at 4 hrs.P-values are derived from Paired t-test and one-way ANOVA and Pearson correlation coefficient were also used to analyze data.Results Table : Changes in S and F of TTS of our study group (n= 33), and changes of 2 and 4 hrs retention of GET (n=26) before and after GES and PP procedures: There was a strong correlation between frequency of TSS and 2h GET r=0.454 (p=0.02).By analyzing each GP symptom and its possible correlation with gastric retention we identified that reduction in S and F of postprandial fullness correlated significantly with acceleration in GET at the 2nd hour time point r=0.39 (p=0.049) for both.18 patients (70%) normalized their GET with <10% retention at 4 hrs.Conclusions: 1) In drug-refractory GP the combination of PP and GES markedly and significantly accelerated gastric emptying, and improved GP symptoms; 2) The increased rate of gastric emptying after PP correlated with symptoms improvements; 3) This comprehensive surgical approach addresses both the subjective and objective goals in treating drug refractory gastroparesis .Summary of the results TSS-Total Symptoms Score (max 28 points) GET-Gastric Emptying Test (% retention) Mo1314