• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Pyloroplasty as a Rescue Procedure for Morbidly Obese Patients with Refractory Gastroparesis after Sleeve Gastrectomy

Keneth Hall, MD, FACS, FASMBS, Raelina S Howell, MD, Harika Boinpally, MD, Patricia Cherasard, PAC, Patrizio Petrone, MD, Collin E Brathwaite, MD, FACS, FASMBS. NYU Winthrop Hospital

Introduction: Patients with morbid obesity and gastroparesis can be treated with sleeve gastrectomy (SG), which has been shown to increase gastric emptying, decrease transit time, and increase glucagon-like peptide levels. Historically, in the setting of refractory gastroparesis following SG, conversion to Roux-en-Y gastric bypass (RNY) was used as a salvage procedure. However, there are limited surgical options for patients with refractory gastroparesis who are poor RNY candidates (ie high risk for anastomotic breakdown such as in Crohn’s disease, high-dose steroids, immunosuppressed) or who are unwilling to undergo RNY. This case series describes the unique surgical management technique of rescue pyloroplasty with sleeve gastrectomy (SG) for patients with morbid obesity (body mass index [BMI] ≥35 kg/m2) and refractory gastroparesis.

Methods: A retrospective chart review was performed for patients with morbid obesity and gastroparesis who underwent SG and simultaneous or subsequent pyloroplasty by a single surgeon at a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Center of Excellence from August 2016 through July 2018. Patient workup, surgical techniques, and outcomes were assessed.

Results: Three patients underwent SG and simultaneous pyloroplasty (n=2) or subsequent pyloroplasty (n=1) and were included in this case series. The first patient was a 70-year-old female with a BMI of 36 who had undergone placement and removal of two prior adjustable gastric bands. She underwent laparoscopic SG, but complained of bloating and dysphagia during postoperative visits and was found to have gastroparesis on a gastric emptying study. She then underwent robotic revision SG and pyloroplasty with subsequent symptom resolution. The second patient was a 46-year-old male with diabetic gastroparesis (hemoglobin A1c 6.8) and a BMI of 40 who was offered RNY, but elected for SG with pyloroplasty and also had postoperative resolution of symptoms. The third case was a 34-year-old female with a BMI 37.8 and idiopathic, refractory gastroparesis who underwent laparoscopic SG and pyloroplasty. She was readmitted on postoperative day seven for liquid intolerance that resolved with conservative, non-operative management and she was discharged home the same day with continued symptom resolution during subsequent follow-up.

Conclusion: We have demonstrated good results with the use of rescue pyloroplasty following SG in patients with morbid obesity and refractory gastroparesis. In patients with gastroparesis who have already undergone sleeve gastrectomy, surgeons should consider pyloroplasty as a salvage maneuver prior to conversion to RNY, keeping in mind that conversion is still an option if symptoms persist.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95335

Program Number: P045

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

View this Poster

368

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2019 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons