Surgical Management for Refractory Gastroparesis: First Comparative Case Series between Gastric Bypass and Pyloroplasty in Colombia

Abstract

Gastroparesis is a common motor disorder of the upper gastrointestinal tract. Surgical management presents a challenge, particularly in regions lacking proprietary data or experience with surgical approaches to this condition. This study aimed to compare surgical outcomes of patients undergoing gastric bypass vs. pyloroplasty for refractory gastroparesis, for the first time in Colombia. A longitudinal study was conducted on 16 patients with refractory gastroparesis undergoing pyloroplasty or laparoscopic gastric bypass at a tertiary referral center in Colombia between January 2018 and December 2020. Ten (62.5%) patients underwent gastric bypass, and 93.8% were women. Surgical time was significantly shorter with pyloroplasty (p = 0.001), as well as time to symptom resolution (50% vs. 30% within the first 24 h, and 100% vs. 70% at 15 days). The preoperative and postoperative mean body mass index (BMI) was 29.7 (21.3—33.4) and 23.1 (20.9—25.4), respectively. Both groups were similar in all analyzed characteristics except for a higher BMI in the gastric bypass group (p = 0.01). Gastric bypass resulted in a reduction of approximately 20% of the baseline BMI value, compared to 5% with pyloroplasty. This study found that both techniques were feasible and safe for surgical treatment of refractory gastroparesis. Gastric bypass may be preferred for obese patients due to greater weight loss, which could impact additional outcomes.