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Johns Hopkins GI doctors use endoscopy to place transpyloric stent
Date:7/3/2013

t all. Symptoms, including reflux, become chronic.

Using an endoscope, Clarke placed a self-expandable, coated metallic stent across the three patients' pyloric channels, holding the channels open and allowing the patients' stomachs to empty normally.

All three patients showed dramatic reductions in symptoms, Clarke says. One was a 15-year-old boy with chronic nausea and vomiting who had endured unsuccessful trials of erythromycin, metoclopramide, domperidone and promethazine. A second was a 54-year-old man with idiopathic gastroparesis who also didn't respond to medication, but had complete recovery after his stent placement. In a third patient, the stent migrated out of place and her pain came back, but after replacing it, the pain eased, Clarke reports. All were treated at The Johns Hopkins Hospital.

Clarke says the stent placement procedure isn't difficult.

"Technically it's pretty simple, and the risk appears to be minimal; if it doesn't work, you just take it out," he says. "Gastric surgery to stimulate emptying is riskier than endoscopy."

The number of patients diagnosed with gastroparesis is on the rise, Clarke says. "I'd estimate that 30 percent of my clinical practice comprises patients with gastroparesis."

Clarke says a larger clinical trial, which he expects to begin in the near future, is needed to provide longer follow-up of results and to identify which patients are likely to benefit the most from stents. "Our hope is that stent placement may become either a primary treatment option or a bridge technology to determine who can best benefit from surgery to improve stomach emptying."


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Contact: Patrick Smith
psmith88@jhmi.edu
410-955-8242
Johns Hopkins Medicine
Source:Eurekalert

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