Affiliation:
1. Department of Gastroenterology and Hepatology Maastricht University Medical Center Maastricht the Netherlands
2. Department of Gastroenterology and Hepatology Maxima Medical Center Veldhoven the Netherlands
Abstract
AbstractBackgroundGastric peroral endoscopic pyloromyotomy (G‐POEM) is a promising therapeutic modality for refractory gastroparesis (GP). However, as characteristics of suitable patients for G‐POEM remain unclear, antro‐duodenal manometry (ADM) has been suggested to provide objective parameters for patient selection. The aim of the present study was to identify ADM parameters as predictors for treatment response after G‐POEM in refractory GP.MethodsRefractory GP patients who underwent a G‐POEM between 2017 and 2022 were included. The following ADM parameters were mainly scored: antral hypomotility, pylorospasm, and the presence of neuropathic enteric patterns. Treatment response was defined as a GCSI‐score decrease of ≥1 point 12 months after G‐POEM. Explorative analyses were performed on potential predictors of response using logistic regression analysis.Key ResultsSixty patients (52 women, mean age 52 ± 14 years.) with refractory GP (33 idiopathic, 16 diabetic, 11 postsurgical) were included. Clinical response data were available for 52 patients. In 8 out of 60 patients, it was not feasible to advance the catheter beyond the pylorus. Abnormal ADM was found in 46/60 patients (77%). Antral hypomotility and pylorospasm were found in respectively 33% and 12% of patients. At least one neuropathic enteric dysmotility pattern was found in 58% of patients. No differences were found when comparing baseline ADM parameters between clinical response groups at 12 months follow‐up. Following explorative analyses, no ADM parameters were identified to predict clinical response 12 months after G‐POEM.Conclusions and InferencesNo ADM parameters were identified as predictors of clinical response after G‐POEM in refractory GP patients. Additionally, a high percentage of abnormal ADM tracings was found, in particular with relation to enteric dysmotility, while only a low percentage of patients showed antral hypomotility or pylorospasm.