Further experience with gastric stimulation to treat drug refractory gastroparesis

Background Gastric electrical stimulation (GES) has been introduced for patients with gastroparesis refractory to pharmacological therapy. Methods From April 1998 until November 2001, 55 patients underwent GES implantation at Kansas University Medical Center. All patients had prolonged gastric retention of a solid meal by scintigraphy at baseline. The etiologies were diabetes mellitus in 39, related to previous surgery in 9, and idiopathic in 7. Symptoms were graded using a 5-point scale and quality of life was assessed with the SF-36 questionnaire. Body mass index and nutritional parameters were monitored. Hemoglobin A1C was measured in the diabetic patients. Results Total symptom scores and the physical and mental composite scores of quality of life improved significantly. On average, gastric emptying did not change. Body mass index and body weight increased significantly. And days spent in hospital admissions were significantly decreased. At 1 year, diabetic patients experienced reduced hemoglobin A1C. Four devices were removed. One patient died of a pulmonary embolus postoperatively. Conclusions In a large series of patients with gastroparesis, GES significantly improved symptoms and quality of life.