Outcomes of pyloroplasty and pyloric dilatation in children diagnosed with nonobstructive delayed gastric emptying

Jawaid, Wajid; Abdalwahab, Ahmed; Blair, Geoffrey K.; Skarsgard, Erik D.; Webber, Eric M.

doi:10.1016/j.jpedsurg.2006.08.005

Cited by 15 publications

(10 citation statements)

References 14 publications

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“…While there are many publications describing pyloroplasty for pediatric patients with delayed gastric emptying, 25,26 reports are limited regarding its use in adults with primary gastric emptying problems. 27 Published reports of laparoscopic pyloroplasty mostly describe its use as an adjunct to anti-reflux surgery in the GERD population with poor gastric emptying.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic and Endoscopic Pyloroplasty for Gastroparesis Results in Sustained Symptom Improvement

Hibbard

Dunst

Swanström

2011

Journal of Gastrointestinal Surgery

157

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Section: Discussionmentioning

confidence: 99%

Laparoscopic and Endoscopic Pyloroplasty for Gastroparesis Results in Sustained Symptom Improvement

Hibbard

Dunst

Swanström

2011

Journal of Gastrointestinal Surgery

157

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“…(2, 3) Gastroparesis is a condition with historical limitations in medical therapy. When medical therapy fails in patients with gastroparesis, they often resort to surgical treatment such as gastrostomy(4, 5) and jejunostomy(6) for nutrition and pyloromyotomy(7), pyloroplasty(7-9) and gastrectomy(10, 11)) to improve gastric emptying. It has recently been suggested that the use of intrapyloric botulinum toxin A injections (IPBI) may be a medical alternative to some surgical procedures.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic intrapyloric injection of botulinum toxin A in the treatment of children with gastroparesis: a retrospective, open-label study

Rodriguez

Rosen

Manfredi

et al. 2012

Gastrointestinal Endoscopy

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Background Botulinum toxin A has been used in children to treat spastic disorders and recently for gastrointestinal conditions. Open label studies in adults with gastroparesis have reported an improvement in symptoms and gastric emptying after endoscopic intrapyloric botulinum injections (IPBI) although placebo controlled trials have shown conflicting results. Only a single case report of IPBI is available in children. Objective Determine the long term clinical outcomes and predictive factors of IPBI response in children with gastroparesis refractory to medical therapy. Design Retrospective review. Setting Single tertiary care center. Patients Children with refractory gastroparesis symptoms undergoing IPBI. Interventions IPBI. Main outcome measurements Clinical improvement and predictive factors of response. Results A total of 70 injections were given to 47 patients (mean age 9.98 ± 6.5 years and 23 were female) with follow up in 45. Only 15 reported failure and 30 reported success to IPBI. The median duration of response of the first IPBI was 3.0 months (1.2-4.8 months CI). A total of 29 patients received a single IPBI and 18 received multiple IPBI. Older age and vomiting predicted response to initial IPBI and male gender predicted response to repeat IPBI. Only 1 patient reported exacerbation of vomiting after IPBI resolving within a week. Limitations Open label and retrospective nature of the study. Conclusion IPBI is safe and may be effective in the management of children with symptoms of gastroparesis. Subgroups identified with response to first IPBI include older patients and those presenting with vomiting whereas males responded better to repeat IPBIs.

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“…Long-term response rates to the balloon dilation between 16 and 80% with nonmalignant PS have been reported [12,19,20]. The literature contains only a few studies and case reports on endoscopic balloon dilation in children with delayed gastric emptying or PS [2,18,[21][22][23]. Tekant et al [1] performed balloon dilation in four patients with PS due to caustic ingestion and reported a 25% success rate.…”

Section: Discussionmentioning

confidence: 99%

Management of pyloric stricture in children: endoscopic balloon dilatation and surgery

et al. 2012

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Outcomes of pyloroplasty and pyloric dilatation in children diagnosed with nonobstructive delayed gastric emptying

Cited by 15 publications

References 14 publications

Laparoscopic and Endoscopic Pyloroplasty for Gastroparesis Results in Sustained Symptom Improvement

Laparoscopic and Endoscopic Pyloroplasty for Gastroparesis Results in Sustained Symptom Improvement

Endoscopic intrapyloric injection of botulinum toxin A in the treatment of children with gastroparesis: a retrospective, open-label study

Management of pyloric stricture in children: endoscopic balloon dilatation and surgery

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