Post-surgical and Obstructive Gastroparesis

Overview

Journal Curr Gastroenterol Rep

Specialty Gastroenterology

Date 2007 Sep 22

PMID 17883974

Citations 25

Authors

Mehnaz A Shafi

P Jay Pasricha

Affiliations

Soon will be listed here.

Abstract

Post-surgical gastroparesis (PSG) is recognized as a consequence of vagal nerve injury following upper abdominal surgery. It has been well documented following vagotomy for peptic ulcer surgery. With the increasing role of surgical treatment in the management of GERD and morbid obesity, PSG is now being diagnosed after fundoplication and bariatric surgery. PSG has also been reported after heart and lung transplantation, possibly due to opportunistic viral infection or motor-inhibitory effects of the immunosuppressive drugs, in addition to vagal nerve injury. Initial postoperative management of PSG should be conservative as many symptoms following abdominal surgery resolve with time. This occurs possibly because the enteric nervous system is able to adapt to the loss of vagal input or vagal reinnervation occurs. Persistent symptoms are difficult to manage and require a multidisciplinary team approach. Gastric electrical stimulation has shown promise in small series.

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References

Yusuf T, Brugge W . Endoscopic therapy of benign pyloric stenosis and gastric outlet obstruction. Curr Opin Gastroenterol. 2006; 22(5):570-3. DOI: 10.1097/01.mog.0000239874.13867.41. View

Lee H, Lennon V, Camilleri M, Prather C . Paraneoplastic gastrointestinal motor dysfunction: clinical and laboratory characteristics. Am J Gastroenterol. 2001; 96(2):373-9. DOI: 10.1111/j.1572-0241.2001.03454.x. View

Eckhauser F, Conrad M, Knol J, Mulholland M, Colletti L . Safety and long-term durability of completion gastrectomy in 81 patients with postsurgical gastroparesis syndrome. Am Surg. 1998; 64(8):711-6; discussion 716-7. View

Soykan I, Sivri B, Sarosiek I, Kiernan B, McCallum R . Demography, clinical characteristics, psychological and abuse profiles, treatment, and long-term follow-up of patients with gastroparesis. Dig Dis Sci. 1998; 43(11):2398-404. DOI: 10.1023/a:1026665728213. View

Bais J, Samsom M, Boudesteijn E, van Rijk P, Akkermans L, Gooszen H . Impact of delayed gastric emptying on the outcome of antireflux surgery. Ann Surg. 2001; 234(2):139-46. PMC: 1421999. DOI: 10.1097/00000658-200108000-00002. View

Mathias J, Fernandez A, Sninsky C, Clench M, Davis R . Nausea, vomiting, and abdominal pain after Roux-en-Y anastomosis: motility of the jejunal limb. Gastroenterology. 1985; 88(1 Pt 1):101-7. DOI: 10.1016/s0016-5085(85)80140-2. View

Lundell L, Myers J, Jamieson G . Delayed gastric emptying and its relationship to symptoms of "gas float" after antireflux surgery. Eur J Surg. 1994; 160(3):161-6. View

Gujar P, Remde A, DeAntonio J . Roux stasis syndrome: clinical improvement with Tegaserod. J Clin Gastroenterol. 2005; 39(6):550-1. DOI: 10.1097/01.mcg.0000165708.63777.79. View

Murr M, Nitecki S, Camilleri M, Prather C, Kelly K, Sarr M . Near-total completion gastrectomy for severe postvagotomy gastric stasis: analysis of early and long-term results in 62 patients. J Gastrointest Surg. 1999; 3(1):15-21, discussion 21-3. DOI: 10.1016/s1091-255x(99)80003-1. View

10.

van der Mijle H, BEEKHUIS H, Bleichrodt R, Kleibeuker J . Transit disorders of the gastric remnant and Roux limb after Roux-en-Y gastrojejunostomy: relation to symptomatology and vagotomy. Br J Surg. 1993; 80(1):60-4. DOI: 10.1002/bjs.1800800122. View

11.

Patterson D . Prokinetic agents in postgastrectomy patients. Gastroenterol Clin North Am. 1994; 23(2):313-25. View

12.

Tanaka M, Sarr M . Role of the duodenum in the control of canine gastrointestinal motility. Gastroenterology. 1988; 94(3):622-9. DOI: 10.1016/0016-5085(88)90232-6. View

13.

Ukleja A, Woodward T, Achem S . Vagus nerve injury with severe diarrhea after laparoscopic antireflux surgery. Dig Dis Sci. 2002; 47(7):1590-3. DOI: 10.1023/a:1015831505810. View

14.

Farrell T, Richardson W, Halkar R, Lyon C, Galloway K, Waring J . Nissen fundoplication improves gastric motility in patients with delayed gastric emptying. Surg Endosc. 2001; 15(3):271-4. DOI: 10.1007/s004640000365. View

15.

Fich A, Neri M, Camilleri M, Kelly K, Phillips S . Stasis syndromes following gastric surgery: clinical and motility features of 60 symptomatic patients. J Clin Gastroenterol. 1990; 12(5):505-12. View

16.

Abell T, Minocha A . Gastrointestinal complications of bariatric surgery: diagnosis and therapy. Am J Med Sci. 2006; 331(4):214-8. DOI: 10.1097/00000441-200604000-00008. View

17.

Fonkalsrud E, Perez C, Quintero R, Martin L, Villasenor E, Atkinson J . Gastric emptying procedures decrease the risk of postoperative recurrent reflux in children with delayed gastric emptying. J Pediatr Surg. 1999; 34(1):79-82; discussion 82-3. DOI: 10.1016/s0022-3468(99)90233-6. View

18.

Oubre B, Luo J, Al-Juburi A, Voeller G, Familoni B, Abell T . Pilot study on gastric electrical stimulation on surgery-associated gastroparesis: long-term outcome. South Med J. 2005; 98(7):693-7. DOI: 10.1097/01.smj.0000168660.77709.4d. View

19.

Petrakis J, Vassilakis J, Karkavitsas N, Tzovaras G, Epanomeritakis E, Tsiaoussis J . Enhancement of gastric emptying of solids by erythromycin in patients with Roux-en-Y gastrojejunostomy. Arch Surg. 1998; 133(7):709-14. DOI: 10.1001/archsurg.133.7.709. View

20.

Kozarek R, Low D, Raltz S . Complications associated with laparoscopic anti-reflux surgery: one multispecialty clinic's experience. Gastrointest Endosc. 1998; 46(6):527-31. DOI: 10.1016/s0016-5107(97)70008-7. View