Dr.Tarek Said's Scientific Publications

EVALUATION OF GASTRIC EMPTYING AFTER GASTRIC PULL UP

Ibrahim Gala Khalifa, MD, Ahmed Farag, MD, and Tarek Said, MD

Department of Surgery, Faculty of Medicine, Cairo University, Cairo, Egypt.

Egyptian Journal of Surgery, Vol (18), No (2), June 1999: 165-170

Gastroparesis is a common sequel after gastric pull up. It was advised to perform a gastric drainage procedure routinely to avoid the development of gastric retention secondary to gastroparesis. However the results were inconsistent and the side effects were compelling. In order to avoid such mishap, a conservative approach was tried in thirty patients with gastric pull up sparing them any form of gastric drainage procedures. Prokinetic therapy and diet control were used to  tide the patients over, until gastroparesis improves spontaneously as expected within few weeks postoperatively. Continuous clinical monitoring as well as gastroscintingraphy (done 3 and 8 weeks postoperative) were used to evaluate the progress of gastric emptying. It was found that 96.7% of patients were symptom free and had adequate gastric emptying within two months postoperative, while 3.3% of patients had persistent vomiting and significant delay in gastric emptying for three months postoperative that was relieved by endoscopic balloon dilatation of the pylorus In conclusion, gastroparesis can be treated conservatively as it is a reversible disorder in the great majority of cases. Gastric drainage is usually associated with notorious side effects and is better to be reserved for the minority of patients in whom gastroparesis will not improve under conservative treatment.

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