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Curr Treat Options Gastroenterol. 2017 Dec;15(4):637-647. doi: 10.1007/s11938-017-0156-9.

Gastric Peroral Endoscopic Pyloromyotomy Therapy for Refractory Gastroparesis.

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Division of Gastroenterology, Hofstra Northwell School of Medicine, Northwell Health System, 300 Community Drive, Manhasset, NY, 11030, USA.
Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Sheikh Zayed Bldg, 1800 Orleans Street, Suite 7125G, Baltimore, MD, 21287, USA.


Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery. Emerging data seems to suggest that not only does G-POEM offer symptomatic and clinical improvement but also objective improvement in follow-up gastric emptying studies in as much as 70% of patients. Summary We believe that with proper patient selection, G-POEM will become a powerful tool for gastroenterologists managing this chronic debilitating disease.


Gastric motility; Gastric peroral endoscopic myotomy (G-POEM); Gastroparesis; Natural orifice transluminal endoscopic surgery (NOTES); Pyloroplasty; Pylorus


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