Addition of pyloroplasty may improve glycemic control and refractory early satiety in gastroparesis at rates similar to gastric neurostimulation alone: a retrospective analysis

Figures & data

Table 1. Characteristics of the study population (N = 42).

			Surgical management
Characteristics		Overall sample, N (%)	GES-only, N = 15	GES + PP, N = 27	P-value
Gastroparesis etiology	Idiopathic	18 (42.9)	6 (14.3)	12 (28.6)	0.780
	Diabetic	24 (57.1)	9 (21.4)	15 (35.7)
Gender	Male	7 (16.7)	4 (9.5)	3 (7.1)	0.195
	Female	35 (83.3)	11 (26.2)	24 (57.1)
Race/Ethnicity	Caucasian	35 (88.1)	13 (31.0)	22 (52.4)	0.666
	Non-Caucasian	7 (14.3)	2 (4.8)	5 (11.9)
Body mass index, kg/m^2, mean (range)		29.9 (17.9 to 55.8)	33.5 (17.9 to 55.8)	27.7 (20.2 to 41.5)	*0.037
Age at surgical evaluation, years, mean (range)		49 (21 to 72)	49 (23 to 72)	48 (21 to 69)	0.842
Age at diagnosis of gastroparesis, years, mean (range)		41 (18 to 68)	42 (21 to 57)	39 (18 to 68)	0.535
Diabetes mellitus subtype	Type 1	11 (26.8)	3 (7.3)	8 (19.5)	0.341
	Type 2	13 (31.7)	6 (14.6)	7 (17.1)

Abbreviations: GES, gastric-electrical stimulation; PP, pyloroplasty/pyloromyotomy.

* Statistically significant.

Table 2. Reported changes in symptoms and rates of hospitalization following surgical treatment for refractory gastroparesis.

		Patient response, N
Category	Treatment group	Significantly improved	Somewhat improved	No change	Somewhat worse	Significantly worse	P Value
Overall symptoms	GES-only	12	2	1	0	0	0.091
	GES + PP	13	9	5	0	0
Nausea	GES-only	10	4	1	0	0	0.080
	GES + PP	10	11	5	0	1
Vomiting	GES-only	11	3	1	0	0	0.107
	GES + PP	12	10	3	1	1
Early satiety	GES-only	9	5	1	0	0	*0.012
	GES + PP	7	8	10	2	0

Abbreviations: GES, gastric electrical stimulation; PP, pyloroplasty/pyloromyotomy.

* Statistically significant.

Table 3. Outcomes of patients with diabetic gastroparesis (N = 24).

Category		Frequency	P-value
Insulin requirements	Increased	2
	Decreased	2
	Unchanged	6
DKA episode frequency	Increased	0
	Decreased	4
	Unchanged	6
HbA1c, Mean ± SD	GES-only, before surgery	13.3 ± 1.1	0.603
	GES-only, after surgery	10.7 ± 6.9
	GES + PP, before surgery	10.1 ± 2.7	*0.034
	GES + PP, after surgery	7.9 ± 1.3

Abbreviations: DKA, diabetic ketoacidosis; GES, gastric electrical stimulation; HbA1c, hemoglobin A1c; PP, pyloroplasty/pyloromyotomy.

* Statistically significant.