Endoluminal Management of Gastroparesis

  • Alisan Fathalizadeh
  • John RodriguezEmail author


Gastroparesis is a functional disorder of the stomach defined as delayed gastric emptying without a clear mechanical obstruction. Despite the increasing prevalence of gastroparesis, the available treatment options remain limited and generally ineffective. For the most severe cases, procedural approaches to this problem are becoming progressively more focused on minimally invasive and endoscopic techniques that are comparable to more invasive surgical procedures. Endoscopic treatment ranges from nutritional support to pyloric-directed therapies including the application of botulinum toxin, dilation, and stenting. More recently, the gastric per oral endoscopic myotomy (G-POEM) or per oral pyloromyotomy (POP) has demonstrated promising results. As a newer technique, it has demonstrated promising results in terms of safety and subjective and objective clinical improvement. As further long-term data and studies are completed, endoluminal treatment options may shift the treatment paradigm and outcomes for patients with gastroparesis.


Gastroparesis Per oral pyloromyotomy (POP) Gastric per oral endoscopic myotomy (G-POEM) Endoluminal surgery Endoscopic pyloroplasty Intramural surgery Pyloroplasty Endoscopy 


  1. 1.
    Storm AC, Ryou M. Advances in the endoscopic management of gastric outflow disorders. Curr Opin Gastroenterol. 2017;33:455–60.PubMedCrossRefPubMedCentralGoogle Scholar
  2. 2.
    Soares RV, Swanstrom LL. Endoscopic approaches to gastroparesis. Curr Opin Gastroenterol. 2015;31(5):368–73.PubMedCrossRefPubMedCentralGoogle Scholar
  3. 3.
    Camilleri M, Parkman HP, Shafi MA, et al. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108:18–38.PubMedCrossRefPubMedCentralGoogle Scholar
  4. 4.
    Parkman HP, Hasler WL, Fisher RS. American Gastroenterological Association medical position statement: diagnosis and treatment of gastroparesis. Gastroenterology. 2004;127:1589–91.PubMedCrossRefPubMedCentralGoogle Scholar
  5. 5.
    Su A, Conklin JL, Sedarat A. Endoscopic therapies for gastroparesis. Curr Gastroenterol Rep. 2018;20(6):25.PubMedCrossRefPubMedCentralGoogle Scholar
  6. 6.
    Olaya I, Gutierrez B, Khashab MA. Stent placement for the treatment of gastroparesis. Gastrointest Endosc Clin N Am. 2019;29(1):107–15.CrossRefGoogle Scholar
  7. 7.
    Clarke JO, Snape WJ Jr. Pyloric sphincter therapy: botulinum toxin, stents, and pyloromyotomy. Gastroenterol Clin N Am. 2015;44:127–36.CrossRefGoogle Scholar
  8. 8.
    Benias PC, Khashab MA. Gastric peroral endoscopic pyloromyotomy therapy for refractory gastroparesis. Curr Treat Options Gastroenterol. 2017;15:637–47.PubMedCrossRefPubMedCentralGoogle Scholar
  9. 9.
    Herman LL, Hoskins WJ, Shike M. Percutaneous endoscopic gastrostomy for decompression of the stomach and small bowel. Gastrointest Endosc. 1992;38(3):314–8.PubMedCrossRefPubMedCentralGoogle Scholar
  10. 10.
    Laval G, Arvieux C, Stefani L, et al. Protocol for the treatment of malignant inoperable bowel obstruction: a prospective study of 80 cases at Grenoble University Hospital Center. J Pain Symptom Manag. 2006;31(6):502–12.CrossRefGoogle Scholar
  11. 11.
    ASGE Standards of Practice Committee, Fukami N, Anderson MA, Khan K, et al. The role of endoscopy in gastroduodenal obstruction and gastroparesis. Gastrointest Endosc. 2011;74(1):13–21.CrossRefGoogle Scholar
  12. 12.
    Pitt HA, Mann LL, Berquist WE, et al. Chronic intestinal pseudo-obstruction. Management with total parenteral nutrition and a venting enterostomy. Arch Surg. 1985;120(5):614–8.PubMedCrossRefPubMedCentralGoogle Scholar
  13. 13.
    Murr MM, Sarr MG, Camilleri M. The surgeon’s role in the treatment of chronic intestinal pseudoobstruction. Am J Gastroenterol. 1995;90(12):2147–51.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Bankhead RR, Fisher CA, Rolandelli RH. Gastrostomy tube placement outcomes: comparison of surgical, endoscopic, and laparoscopic methods. Nutr Clin Pract. 2005;20(6):607–12.PubMedCrossRefPubMedCentralGoogle Scholar
  15. 15.
    Ljungdahl M, Sundbom M. Complication rate lower after percutaneous endoscopic gastrostomy than after surgical gastrostomy: a prospective, randomized trial. Surg Endosc. 2006;20(8):1248–51.PubMedCrossRefPubMedCentralGoogle Scholar
  16. 16.
    Silas AM, Pearce LF, Lestina LS, et al. Percutaneous radiologic gastrostomy versus percutaneous endoscopic gastrostomy: a comparison of indications, complications and outcomes in 370 patients. Eur J Radiol. 2005;56(1):84–90.PubMedCrossRefPubMedCentralGoogle Scholar
  17. 17.
    Committee AT, Kwon RS, Banerjee S, et al. Enteral nutrition access devices. Gastrointest Endosc. 2010;72(2):236–48.CrossRefGoogle Scholar
  18. 18.
    Committee AT, Enestvedt BK, Jorgensen J, et al. Endoscopic approaches to enteral feeding and nutrition core curriculum. Gastrointest Endosc. 2014;80(1):34–41.CrossRefGoogle Scholar
  19. 19.
    Byrne KR, Fang JC. Endoscopic placement of enteral feeding catheters. Curr Opin Gastroenterol. 2006;22(5):546–50.PubMedCrossRefPubMedCentralGoogle Scholar
  20. 20.
    Camilleri M, Parkman HP, Shafi MA, et al. American College of G. Clinical guideline: management of gastroparesis. Am J Gastroenterol. 2013;108(1):18–37.PubMedCrossRefPubMedCentralGoogle Scholar
  21. 21.
    Fontana RJ, Barnett JL. Jejunostomy tube placement in refractory diabetic gastroparesis: a retrospective review. Am J Gastroenterol. 1996;91(10):2174–8.PubMedPubMedCentralGoogle Scholar
  22. 22.
    Karamanolis G, Tack J. Nutrition and motility disorders. Best Pract Res Clin Gastroenterol. 2006;20(3):485–505.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Maple JT, Petersen BT, Baron TH, et al. Direct percutaneous endoscopic jejunostomy: outcomes in 307 consecutive attempts. Am J Gastroenterol. 2005;100(12):2681–8.PubMedCrossRefPubMedCentralGoogle Scholar
  24. 24.
    Fan AC, Baron TH, Rumalla A, Harewood GC. Comparison of direct percutaneous endoscopic jejunostomy and PEG with jejunal extension. Gastrointest Endosc. 2002;56(6):890–4.PubMedCrossRefPubMedCentralGoogle Scholar
  25. 25.
    Fortunato JE, Darbari A, Mitchell SE, et al. The limitations of gastro-jejunal (G-J) feeding tubes in children: a 9-year pediatric hospital database analysis. Am J Gastroenterol. 2005;100(1):186–9.PubMedCrossRefPubMedCentralGoogle Scholar
  26. 26.
    Zopf Y, Rabe C, Bruckmoser T, et al. Percutaneous endoscopic jejunostomy and jejunal extension tube through percutaneous endoscopic gastrostomy: a retrospective analysis of success, complications and outcome. Digestion. 2009;79(2):92–7.PubMedCrossRefPubMedCentralGoogle Scholar
  27. 27.
    Delegge M, Buck G, Fang J, et al. Randomized prospective comparison of Direct Percutaneous Endoscopic Jejunostomy (DPEJ) feeding tube placement versus Percutaneous Endoscopic Gastrostomy Feeding Tube Placement with Jejunal Extension (PEG-J), for enteral feeding. Gastrointest Endosc. 2006;63(5):AB160.CrossRefGoogle Scholar
  28. 28.
    Udorah MO, Fleischman MW, Bala V, Cai Q. Endoscopic clips prevent displacement of intestinal feeding tubes: a long-term follow-up study. Dig Dis Sci. 2010;55(2):371–4.PubMedCrossRefPubMedCentralGoogle Scholar
  29. 29.
    Smith D, Soucy P. Complications of long-term jejunostomy in children. J Pediatr Surg. 1996;31(6):787–90.PubMedCrossRefPubMedCentralGoogle Scholar
  30. 30.
    Myers JG, Page CP, Stewart RM, et al. Complications of needle catheter jejunostomy in 2,022 consecutive applications. Am J Surg. 1995;170(6):547–50.PubMedCrossRefPubMedCentralGoogle Scholar
  31. 31.
    Wiesel PH, Schneider R, Dorta G, et al. Botulinum toxin for refractory postoperative pyloric spasm. Endoscopy. 1997;29(2):132.PubMedCrossRefPubMedCentralGoogle Scholar
  32. 32.
    Jackson AS, Aye RW. Endoscopic approaches to cricopharyngeal myotomy and pyloromyotomy. Thorac Surg Clin. 2018;28:507–20.PubMedCrossRefGoogle Scholar
  33. 33.
    Malik Z, Kataria R, Modayil R, et al. Gastric per oral endoscopic myotomy (G-POEM) for the treatment of refractory gastroparesis: early experience. Dig Dis Sci. 2018;63:2405–12.PubMedCrossRefPubMedCentralGoogle Scholar
  34. 34.
    James AN, Ryan JP, Parkman HP. Inhibitory effects of botulinum toxin on pyloric and antral smooth muscle. Am J Physiol Gastrointest Liver Physiol. 2003;285(2):G291–7.PubMedCrossRefGoogle Scholar
  35. 35.
    Bromer MQ, Friedenberg F, Miller LS, et al. Endoscopic pyloric injection of botulinum toxin A for the treatment of refractory gastroparesis. Gastrointest Endosc. 2005;61(7):833–9.PubMedCrossRefPubMedCentralGoogle Scholar
  36. 36.
    Ezzeddine D, Jit R, Katz N, Gopalswamy N, Bhutani MS. Pyloric injection of botulinum toxin for treatment of diabetic gastroparesis. Gastrointest Endosc. 2002;55:920–3.PubMedCrossRefPubMedCentralGoogle Scholar
  37. 37.
    Lacy BE, Crowell MD, Schettler-Duncan A, et al. The treatment of diabetic gastroparesis with botulinum toxin injection of the pylorus. Diabetes Care. 2004;27:2341–7.PubMedCrossRefPubMedCentralGoogle Scholar
  38. 38.
    Thomas A, de Souza RB, Malespin M, de Melo SW Jr. Botulinum toxin as a treatment for refractory gastroparesis: a literature review. Curr Treat Options Gastroenterol. 2018;16(4):479–88.PubMedCrossRefPubMedCentralGoogle Scholar
  39. 39.
    Friedenberg FK, Palit A, Parkman HP, et al. Botulinum toxin A for the treatment of delayed gastric emptying. Am J Gastroenterol. 2008;103(2):416–23.PubMedCrossRefPubMedCentralGoogle Scholar
  40. 40.
    Arts J, Holvoet L, Caenepeel P, et al. Clinical trial: a randomized-controlled crossover study of intrapyloric injection of botulinum toxin in gastroparesis. Aliment Pharmacol Ther. 2007;26(9):1251–8.PubMedCrossRefPubMedCentralGoogle Scholar
  41. 41.
    Kahaleh M, Gonzalez JM, Xu M, et al. Gastric peroral endoscopic myotomy for the treatment of refractory gastroparesis: a multicenter international experience. Endoscopy. 2018;50:1053–8.PubMedPubMedCentralGoogle Scholar
  42. 42.
    Coleski R, Anderson MA, Hasler WL. Factors associated with symptom response to pyloric injection of botulinum toxin in a large series of gastroparesis patients. Dig Dis Sci. 2009;54:2634–42.PubMedCrossRefPubMedCentralGoogle Scholar
  43. 43.
    Wellington J, Scott B, Kundu S, et al. Effect of endoscopic pyloric therapies for patients with nausea and vomiting and functional obstructive gastroparesis. Auton Neurosci. 2017;202:56–61.PubMedCrossRefPubMedCentralGoogle Scholar
  44. 44.
    Avalos DJ, Sarosiek I, Loganathan P, McCallum RW. Diabetic gastroparesis: current challenges and future prospects. Clin Exp Gastroenterol. 2018;11:347–63.PubMedPubMedCentralCrossRefGoogle Scholar
  45. 45.
    Yin G, Tan W, Hu D. Endoscopic ultrasonography-guided intrapyloric injection of botulinum toxin to treat diabetic gastroparesis. Dig Endosc. 2016;28(7):759.PubMedCrossRefPubMedCentralGoogle Scholar
  46. 46.
    Guo H, Fang C, Huang Y, et al. Treatment of diabetic gastroparesis with botulinum toxin injection guided by endoscopic ultrasound in a patient with type 1 diabetes: the first report. Acta Diabetol. 2017;54(5):509–11.PubMedCrossRefPubMedCentralGoogle Scholar
  47. 47.
    Gourcerol G, Tissier F, Melchior C, et al. Impaired fasting pyloric compliance in gastroparesis and the therapeutic response to pyloric dilatation. Aliment Pharmacol Ther. 2015;41(4):360–7.PubMedCrossRefPubMedCentralGoogle Scholar
  48. 48.
    Khashab MA, Besharati S, Ngamruenphong S, et al. Refractory gastroparesis can be successfully managed with endoscopic transpyloric stent placement and fixation (with video). Gastrointest Endosc. 2015;82:1106–9.PubMedCrossRefPubMedCentralGoogle Scholar
  49. 49.
    Clarke JO, Sharaiha RZ, Kord Valeshabad A, et al. Through-the-scope transpyloric stent placement improves symptoms and gastric emptying in patients with gastroparesis. Endoscopy. 2013;45(Suppl 2 UCTN):E189–90.PubMedPubMedCentralGoogle Scholar
  50. 50.
    Chaves DM, de Moura EG, Mestieri LH, et al. Endoscopic pyloromyotomy via a gastric submucosal tunnel dissection for the treatment of gastroparesis after surgical vagal lesion. Gastrointest Endosc. 2014;80:164.PubMedCrossRefPubMedCentralGoogle Scholar
  51. 51.
    Park P, Bergstrom M, Ikeda K, et al. Endoscopic pyloroplasty with full-thickness transgastric and transduodenal myotomy with sutured closure. Gastrointest Endosc. 2007;66(1):116–20.PubMedCrossRefPubMedCentralGoogle Scholar
  52. 52.
    Landreneau J, Strong AT, El-Hayek K, et al. Laparoscopic pyloroplasty versus endoscopic per-oral pyloromyotomy for the treatment of gastroparesis. Surg Endosc. 2019;33(3):773–81.PubMedCrossRefPubMedCentralGoogle Scholar
  53. 53.
    Chung H, Khashab M. Gastric peroral endoscopic myotomy. Clin Endosc. 2018;51:28–32.PubMedPubMedCentralCrossRefGoogle Scholar
  54. 54.
    Sumiyama K, Gostout CJ, Rajan E, et al. Submucosal endoscopy with mucosal flap safety valve. Gastrointest Endosc. 2007;65:688–94.PubMedCrossRefPubMedCentralGoogle Scholar
  55. 55.
    Inoue H, Minami H, Kobayashi Y, et al. Peroral endoscopic myotomy (POEM) for esophageal achalasia. Endoscopy. 2010;42:265–71.PubMedCrossRefPubMedCentralGoogle Scholar
  56. 56.
    Ortega JA, Madureri V, Perez L. Endoscopic myotomy in the treatment of achalasia. Gastrointest Endosc. 1980;26:8–10.PubMedCrossRefPubMedCentralGoogle Scholar
  57. 57.
    Mahmoud M, Holzwanger E, Wassef W. Gastric interventional endoscopy. Curr Opin Gastroenterol. 2017;33:461–6.PubMedCrossRefPubMedCentralGoogle Scholar
  58. 58.
    Stavropoulos SN, Desilets DJ, Fuchs KH, et al. Per-oral endoscopic myotomy white paper summary. Surg Endosc. 2014;28:2005–19.PubMedCrossRefPubMedCentralGoogle Scholar
  59. 59.
    Chen YI, Inoue H, Ujiki M, et al. An international multicenter study evaluating the clinical efficacy and safety of per-oral endoscopic myotomy in octogenarians. Gastrointest Endosc. 2018;87(4):956–61.PubMedCrossRefPubMedCentralGoogle Scholar
  60. 60.
    Marano L, Pallabazzer G, Solito B, et al. Surgery or peroral esophageal myotomy for achalasia: a systematic review and meta-analysis. Medicine. 2016;95:e3001.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Rodriguez J, Strong AT, Haskins IN, et al. Per-oral pyloromyotomy (POP) for medically refractory gastroparesis: short term results from the first 100 patients at a high volume center. Ann Surg. 2018;268:421–30.PubMedCrossRefPubMedCentralGoogle Scholar
  62. 62.
    Ibarguen-Secchia E. Endoscopic pyloromyotomy for congenital pyloric stenosis. Gastrointest Endosc. 2005;61:598–600.PubMedCrossRefPubMedCentralGoogle Scholar
  63. 63.
    Zhang YX, Nie YQ, Xiao X, et al. Treatment of congenital hypertrophic pyloric stenosis with endoscopic pyloromyotomy. Zhonghua Er Ke Za Zhi. 2008;46:247–51.PubMedPubMedCentralGoogle Scholar
  64. 64.
    Kawai M, Peretta S, Burckhardt O, et al. Endoscopic pyloromyotomy: a new concept of minimally invasive surgery for pyloric stenosis. Endoscopy. 2012;44:169–73.PubMedCrossRefPubMedCentralGoogle Scholar
  65. 65.
    Khashab MA, Stein E, Clarke JO, et al. Gastric peroral endoscopic myotomy for refractory gastroparesis: first human endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2013;78(5):764–8.PubMedCrossRefPubMedCentralGoogle Scholar
  66. 66.
    Chung H, Dallemagne B, Perretta S, et al. Endoscopic pyloromyotomy for postesophagectomy gastric outlet obstruction. Endoscopy. 2014;46(Suppl 1 UCTN):E345–6.PubMedGoogle Scholar
  67. 67.
    Gonzalez JM, Lestelle V, Benezech A, et al. Gastric per-oral endoscopic myotomy with antropyloromyotomy in the treatment of refractory gastroparesis: clinical experience with follow-up and scintigraphic evaluation (with video). Gastrointest Endosc. 2017;85(1):132–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Gonzalez J-M, Vanbiervliet G, Vitton V, et al. First European human gastric peroral endoscopic myotomy, for treatment of refractory gastroparesis. Endoscopy. 2015;47(1):E135–6.PubMedGoogle Scholar
  69. 69.
    Allemang MT, Strong AT, Haskins IN, et al. How I do it: per-oral pyloromyotomy (POP). J Gastrointest Surg. 2017;21(11):1963–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Rodriguez JH, Haskins IN, Strong AT, et al. Per oral endoscopic pyloromyotomy for refractory gastroparesis: initial results from a single institution. Surg Endosc Other Interv Tech. 2017;31(12):1–8.Google Scholar
  71. 71.
    Shlomovitz E, Pescarus R, Cassera MA, et al. Early human experience with per-oral endoscopic pyloromyotomy (POP). Surg Endosc. 2015;29(3):543–51.PubMedCrossRefGoogle Scholar
  72. 72.
    Dacha S, Mekaroonkamol P, Li L, et al. Outcomes and quality-of-life assessment after gastric per-oral endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2017;86(2):282–9.PubMedCrossRefGoogle Scholar
  73. 73.
    Mekaroonkamol P, Dacha S, Patel V, et al. Outcomes of per oral endoscopic pyloromyotomy in the United States. Gastrointest Endosc Clin N Am. 2019;29:151–60.PubMedCrossRefGoogle Scholar
  74. 74.
    Gonzalez JM, Benezech A, Vitton V, Barthet M. G-POEM with antro-pyloromyotomy for the treatment of refractory gastroparesis: mid-term follow-up and factors predicting outcome. Aliment Pharmacol Ther. 2017;46:364–70.PubMedCrossRefGoogle Scholar
  75. 75.
    Xue HB, Fan HZ, Meng XM, et al. Fluoroscopy-guided gastric peroral endoscopic pyloromyotomy (G-POEM): a more reliable and efficient method for treatment of refractory gastroparesis. Surg Endosc. 2017;31:4617–24.PubMedCrossRefGoogle Scholar
  76. 76.
    Khashab MA, Ngamruengphong S, Carr-Locke D, et al. Gastric per-oral endoscopic myotomy for refractory gastroparesis: results from the first multicenter study on endoscopic pyloromyotomy (with video). Gastrointest Endosc. 2017;85:123–8.PubMedCrossRefPubMedCentralGoogle Scholar
  77. 77.
    Mekaroonkamol P, Dacha S, Wang L, et al. Gastric peroral endoscopic pyloromyotomy reduces symptoms, increases quality of life, and reduces health care use for patients with gastroparesis. Clin Gastroenterol Hepatol. 2019;17(1):82–9.PubMedCrossRefPubMedCentralGoogle Scholar
  78. 78.
    Jacques J, Pagnon L, Hure F, et al. Peroral endoscopic pyloromyotomy is efficacious and safe for refractory gastroparesis: prospective trial with assessment of pyloric function. Endoscopy. 2019;17(1):82–9.Google Scholar
  79. 79.
    Koul A, Dacha S, Mekaroonkamol P. Fluoroscopic gastric peroral endoscopic pyloromyotomy (G-POEM) in patients with a failed gastric electrical stimulator. Gastroenterol Rep. 2018;6(2):122–6.CrossRefGoogle Scholar
  80. 80.
    Snape WJ, Lin MS, Agarwal N, Shaw RE. Evaluation of the pylorus with concurrent intraluminal pressure and EndoFLIP in patients with nausea and vomiting. Neurogastroenterol Motil. 2016;28(5):758–64.PubMedCrossRefPubMedCentralGoogle Scholar
  81. 81.
    Malik Z, Sankineni A, Parkman HP. Assessing pyloric sphincter pathophysiology using EndoFLIP in patients with gastroparesis. Neurogastroenterol Motil. 2015;27:524–31.PubMedCrossRefPubMedCentralGoogle Scholar
  82. 82.
    Khoury T, Mizrahi M, Mahamid M, et al. State of the art review with literature summary on gastric peroral endoscopic pyloromyotomy for gastroparesis. J Gastroenterol Hepatol. 2018;33:1829–33.PubMedCrossRefPubMedCentralGoogle Scholar
  83. 83.
    Bratzler DW, Houck PM. Antimicrobial prophylaxis for surgery: an advisory statement from the National Surgical Infection Prevention Project. Am J Surg. 2005;189(4):395–404.PubMedCrossRefPubMedCentralGoogle Scholar
  84. 84.
    Jacques J, Legros R, Monteil J, et al. Outcomes and future directions of per-oral endoscopic pyloromyotomy: a view from France. Gastrointest Endosc Clin N Am. 2019;29:139–49.PubMedCrossRefPubMedCentralGoogle Scholar
  85. 85.
    Lo SK, Fujii-Lau LL, Enestvedt BK, et al. The use of carbon dioxide in gastrointestinal endoscopy. Gastrointest Endosc [Internet]. 2016;83(5):857–65.CrossRefGoogle Scholar
  86. 86.
    Jung Y, Lee J, Gromski MA, et al. Assessment of the length of myotomy in peroral endoscopic pyloromyotomy (G-POEM) using a submucosal tunnel technique (video). Surg Endosc Other Interv Tech. 2015;29(8):2377–84.CrossRefGoogle Scholar
  87. 87.
    Mekaroonkamol P, Li L, Cai Q. The role of pyloric manometry in gastric per-oral endoscopic pyloromyotomy (G-POEM): response to Jacques et al. Neurogastroenterol Motil. 2017;29(1):e12949.CrossRefGoogle Scholar
  88. 88.
    Abell TL, Camilleri M, Donohoe K, et al. Consensus recommendations for gastric emptying scintigraphy: a joint report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine. Am J Gastroenterol. 2008;103(3):753–63.PubMedCrossRefPubMedCentralGoogle Scholar
  89. 89.
    Gonlachanvit S, Maurer A, Fisher R, et al. Regional gastric emptying abnormalities in functional dyspepsia and gastro-oesophageal reflux disease. Neurogastroenterol Motil. 2006;18(10):894–904.PubMedCrossRefPubMedCentralGoogle Scholar
  90. 90.
    Maurer AH, Parkman HP. Update on gastrointestinal scintigraphy. Semin Nucl Med. 2006;36(2):110–8.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    Bortolotti M. Gastric electrical stimulation for gastroparesis: a goal greatly pursued, but not yet attained. World J Gastroenterol. 2011;17:273–82.PubMedPubMedCentralCrossRefGoogle Scholar
  92. 92.
    McCallum RW, Snape W, Brody F, et al. Gastric electrical stimulation with Enterra therapy improves symptoms from diabetic gastroparesis in a prospective study. Clin Gastroenterol Hepatol. 2010;8:947–54.PubMedCrossRefPubMedCentralGoogle Scholar
  93. 93.
    Jayanthi NVG, Dexter SPL, Sarela AI, The Leeds Gastroparesis Multi-Disciplinary Team. Gastric electrical stimulation for treatment of clinically severe gastroparesis. J Minim Access Surg. 2013;9:163–7.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Ross J, Masrur M, Gonzalez-Heredia R, Elli EF. Effectiveness of gastric neurostimulation in patients with gastroparesis. JSLS. 2014;18:e2014.00400.PubMedPubMedCentralCrossRefGoogle Scholar
  95. 95.
    Velanovich V. Quality of life and symptomatic response to gastric neurostimulation for gastroparesis. J Gastrointest Surg. 2008;12:1656–62.PubMedCrossRefPubMedCentralGoogle Scholar
  96. 96.
    Ayinala S, Batista O, Goyal A, et al. Temporary gastric electrical stimulation with orally or PEG placed electrodes in patients with drug refractory gastroparesis. Gastrointest Endosc. 2005;61(3):455–61.PubMedCrossRefPubMedCentralGoogle Scholar
  97. 97.
    Abell TL, Johnson WD, Kedar A, et al. A double-masked, randomized, placebo controlled trial of temporary endoscopic mucosal gastric electrical stimulation for gastroparesis. Gastrointest Endosc. 2011;74(3):496–503.e3.PubMedPubMedCentralCrossRefGoogle Scholar
  98. 98.
    Deb S, Tang SJ, Abell TL, et al. Development of innovative techniques for the endoscopic implantation and securing of a novel, wireless, miniature gastrostimulator (with videos). Gastrointest Endosc. 2012;76(1):179–84.PubMedPubMedCentralCrossRefGoogle Scholar
  99. 99.
    Deb S, Tang SJ, Abell TL, et al. An endoscopic wireless gastrostimulator (with video). Gastrointest Endosc. 2012;75(2):411–5.PubMedPubMedCentralCrossRefGoogle Scholar
  100. 100.
    Hajer J, Novak M. Development of an autonomous endoscopically implantable submucosal microdevice capable of neurostimulation in the gastrointestinal tract. Gastroenterol Res Pract. 2017;2017:1–8.CrossRefGoogle Scholar
  101. 101.
    Choi YB. Laparoscopic gastrojejunostomy for palliation of gastric outlet obstruction in unresectable gastric cancer. Surg Endosc. 2002;16(11):1620–6.PubMedCrossRefPubMedCentralGoogle Scholar
  102. 102.
    Chiu CC, Wang W, Huang MT, et al. Palliative gastrojejunostomy for advanced gastric antral cancer: double scope technique. J Laparoendosc Adv Surg Tech A. 2006;16(2):133–6.PubMedCrossRefPubMedCentralGoogle Scholar
  103. 103.
    Tyberg A, Perez-Miranda M, Sanchez-Ocana R, et al. Endoscopic ultrasound-guided gastrojejunostomy with a lumen-apposing metal stent: a multicenter, international experience. Endosc Int Open. 2016;4(3):E276–81.PubMedPubMedCentralCrossRefGoogle Scholar
  104. 104.
    Khashab MA, Bukhari M, Baron TH, et al. International multicenter comparative trial of endoscopic ultrasonography-guided gastroenterostomy versus surgical gastrojejunostomy for the treatment of malignant gastric outlet obstruction. Endosc Int Open. 2017;5(4):E275–E81.PubMedPubMedCentralCrossRefGoogle Scholar
  105. 105.
    Itoi T, Itokawa F, Uraoka T, et al. Novel EUS-guided gastrojejunostomy technique using a new double-balloon enteric tube and lumen-apposing metal stent (with videos). Gastrointest Endosc. 2013;78:934–9.PubMedCrossRefPubMedCentralGoogle Scholar

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Authors and Affiliations

  1. 1.Minimally Invasive Surgery and Surgical EndoscopyCleveland Clinic FoundationClevelandUSA

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