The aim of the study was the evaluation of efficacy of the resection with pyloric retention proposed by the authors as a method for prevention of post gastroresectional damping syndrome in patients with ulcers. Resection with pyloric retention is performed in six modifications of three basic methods of resections. We have the experience of using this approach in 712 clinical cases. Among them 237 were women and 475 were men 19-75 years of age. It was shown that resection with pyloric retention provides rhythmic evacuation and prevents development of damping syndrome and duodenal reflux. It was found that the main reasons of the development of postgastroresectional syndromes include wide-area mobilization of the stomach and resection of the small curvature, which induce insufficiency of cardia, atony, chronic disturbances of the duodenal passing. Due to the retention of pyloric function damping syndrome have been developed only in 3 patients. In all these cases the syndrome was mild. It may be concluded that gastric resection with pyloric retention represents the most "physiological" intervention and has many advantages in comparison with other methods.
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Acta Biomater
January 2025
Department of Engineering Mechanics, State Key Laboratory of Structural Analysis, Optimization and CAE Software for Industrial Equipment, Dalian University of Technology, Dalian 116024, China.
Gastroretentive systems have gained attention due to their prolonged retention time in the human body, and they have the potential to improve treatment effects, simplify treatment regimens, and improve patient compliance. Among these systems, expandable gastroretentive systems (EGRSs) have emerged as an important type of carrier that can reside in the stomach for a desired period through on-demand expansion for drug delivery, obesity intervention, and medical diagnosis. As the physiological environment significantly influences the performance of EGRSs, here, the physiological factors such as the stomach's physiological structure and activity pattern, and the character of gastric juice are summarized.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Department of Gastroenterology, The First Affiliated Hospital of Shenzhen University, Shenzhen Second People's Hospital, Shenzhen, China.
J Gastrointest Surg
January 2025
Case Western Reserve University School of Medicine, Cleveland, OH, United States; Division of General Surgery, Department of Surgery, The MetroHealth System, Cleveland, OH, United States.
Background: Per-oral pyloromyotomy (POP), also known as gastric per-oral endoscopic myotomy, is the first-line endoscopic intervention for medically refractory gastroparesis. This study aimed to assess the value of pyloric impedance planimetry using a functional lumen imaging probe (FLIP) during POP.
Methods: Patients who underwent POP between October 2019 and February 2024 were retrospectively reviewed.
J Gastrointest Surg
November 2024
Foregut Division, Surgical Institute, Allegheny Health Network, Pittsburgh, PA, United States; Chevalier Jackson Research Foundation, Esophageal Institute, Western Pennsylvania Hospital, Pittsburgh, PA, United States; Department of Surgery, Drexel University, Philadelphia, PA, United States. Electronic address:
Background: Pyloroplasty is an effective surgery for gastroparesis. However, some patients fail to improve after pyloric drainage and may require subsequent gastric electric stimulation. There is a paucity of data on the efficacy of gastric stimulator as an adjunct to failed pyloroplasty.
View Article and Find Full Text PDFGastrointest Endosc
October 2024
Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Background And Aims: Gastric balloons and endoscopic sleeve gastroplasty appear to work by delaying gastric emptying. We hypothesized that pylorus-sparing antral myotomy would inhibit the antral pump, inducing gastric retention and similarly resulting in weight loss.
Methods: In this single-center pilot study, we assessed bariatric endoscopic antral myotomy (BEAM) using submucosal tunneling.
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