Table 2.
Surgical and endoscopic options
|
|
PRO
|
CONS
|
| Surgical options | ||
| Pyloromyotomy | (1) High technical success rate; and (2) Improvement in GCSI and GES | (1) Risk of gastric outlet obstruction and leakage; (2) Invasive; and (3) Time consuming |
| Electrical stimulator | (1) Test response with temporary device; and (2) Predictive features are male sex, diabetic etiology and short duration of disease | High rate of long term complications (infection, erosion, migration, perforation and chronic pain) |
| Endoscopic options | ||
| Botulinum toxin | (1) Easy and tolerable procedure; (2) Repeatable; and (3) Predictive for response to other pyloric techniques | (1) Moot in literature; and (2) Can induce sclerosis and anatomic alteration of pyloric region |
| Pyloric stent placement | (1) Temporized technique; and (2) Predictive for response to other pyloric targeted techniques | Risk of stent migration and duodenal perforation |
GCSI: Gastroparesis cardinal symptoms index; GES: Gastric electrical stimulator.