Botulinum Toxin Injection for the Treatment of Delayed Gastric Emptying Following Pylorus-Preserving Gastrectomy: an Initial Experience

• Published in: Journal of gastric cancer Vol. 17; no. 2; pp. 173 - 179
• Main Authors: Lee, Jung Hwan, Kim, Chan Gyoo, Kim, Young-Woo, Choi, Il Ju, Lee, Jong Yeul, Cho, Soo-Jeong, Kim, Young-Il, Eom, Bang Wool, Yoon, Hong Man, Ryu, Keun Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Gastric Cancer Association 01-06-2017; 대한위암학회
• Subjects: How I Do It; 일반외과학; Gastric stasis; Endoscopy; Botulinum toxins; Gastrectomy; Complications; Surgery
• ISSN: 2093-582X; 2093-5641
• DOI: 10.5230/jgc.2017.17.e18

To report our experience of endoscopic botulinum toxin injection in patients who experienced severe delayed gastric emptying after pylorus-preserving gastrectomy (PPG).
We reviewed the medical records of 6 patients who received the botulinum toxin injection. They presented with severe delayed gastric emptying in the early postoperative period. Endoscopic botulinum toxin was administered as 4 injections of 25-50 IU into each of the 4 quadrants of the prepyloric area.
All botulinum toxin injections were successful without any complications, enabling 5 patients to tolerate soft solid diets and one to tolerate a soft fluid diet within 10 days. The endoscopic criteria of 4 patients improved. Symptom recurrence caused 2 patients to undergo repeat injections that were successful. The median follow-up period was 27 months, and all patients could ingest normal regular diets at the last follow-up.
Endoscopic botulinum toxin injection is a feasible treatment option for early delayed gastric emptying after PPG.