Abstract：
Gastroparesis is a common complaint among patients with diabetes. Symptoms tend to improve following successful pancreas transplantation (PTx), but persist despite euglycemia in a subset of patients. We aimed to assess the benefit of gastric peroral endoscopic myotomy (G-POEM) in persistent gastroparesis following PTx. This was a single center retrospective review of all patients who underwent G-POEM for persistent gastroparesis following PTx. Patient demographics, pre and post procedure perception of symptom severity according to the patient assessment of upper gastrointestinal symptoms severity index (PAGI-SYM), gastroparesis cardinal symptom index (GCSI) score, and 36-item short form survey (SF36) score along with gastric emptying scintigraphy (GES) were analyzed. Seven PTx recipients underwent G-POEM for persistent gastroparesis symptoms. The majority were female. All reported nausea/vomiting, abdominal pain, bloating, and post prandial fullness prior to G-POEM. The post procedure survey scores improved in all patients although this was not significant. The improvement in gastric emptying on GES was statistically significant. G-POEM is a relatively new treatment option for gastroparesis. While it requires specialized proceduralist and training, we have documented improvement in the management of symptoms. With increasing experience, we anticipate more significant benefit in post PTx patients with persistent symptoms of gastroparesis undergoing G-POEM.
摘要：
胃轻瘫是糖尿病患者的常见病。成功的胰腺移植（PTx）后症状趋于改善，但尽管一部分患者血糖正常，但仍然存在。我们旨在评估经口内镜下胃肌切开术（G-POEM）在PTx后持续性胃轻瘫中的益处。这是对所有因PTx后持续性胃轻瘫而接受G-POEM的患者的单中心回顾性研究。患者人口统计学，根据患者对上消化道症状严重程度指数（PAGI-SYM）的评估，手术前后对症状严重程度的感知，胃轻瘫基数症状指数（GCSI）评分，分析了36项简短表格调查（SF36）评分以及胃排空闪烁显像（GES）。7名PTx接受者因持续性胃轻瘫症状接受了G-POEM治疗。大多数是女性。所有报告的恶心/呕吐，腹痛,腹胀,以及在G-POEM之前的餐后饱满度。所有患者的术后调查得分均有所改善，尽管这并不明显。GES的胃排空改善具有统计学意义。G-POEM是胃轻瘫的相对较新的治疗选择。虽然它需要专门的程序主义者和培训，我们记录了症状管理的改善。随着经验的增加,我们预计在PTx后有持续胃轻瘫症状的患者接受G-POEM的获益更显著.
