EUS-guided gastroenterostomy to treat refractory gastroparesis: preliminary results of the first german experience

Aims Gastroparesis is a motility disorder of the stomach characterized by a delayed emptying of food into the small bowel in the absence of mechanical obstruction. Medical treatment is difficult and symptoms such as epigastric pain, nausea and vomiting can lead to a significantly reduced quality of life. As endosonographic-guided gastroenterostomy facilitates gastric emptying in patients with gastric outlet obstruction and has proven to be a save and effective in numerous clinical trials, it might also be a viable option to treat refractory gastroparesis. The aim of the study was to report the first experience with that approach and to evaluate its feasibility and efficacy.

Methods The data of 7 patients with refractory gastroparesis that underwent EUS-GE between march 2021 and august 2023 were retrospectively collected and analyzed. Primary endpoint was to assess the clinical success of the intervention which was defined as reduction in gastroparesis cardinal symptom index of at least 50%. Secondary endpoints were to assess the stent patency, adverse events and the rate of reinterventions.

Results Technical and clinical success rate was 100% with a mean reduction in gastroparesis cardinal symptom index of 69%. During the still ongoing surveillance 2 stents had to be replaced after 12 months due to ingrowth, the other 5 stents still remain patent to this day after up to 2.5 years. We observed 2 stent obstructions in one patient due to food which had to be removed gastroscopically. No major stent related adverse events or mortalities have been observed.

Conclusions In our collective the EUS-guided-gastroenterostomy effectively reduced the symptom burden of gastroparesis refractory to medical treatment.

Conflicts of interest

Authors do not have any conflict of interest to disclose.

Publication History

Article published online:
15 April 2024