Endoscopic pyloric balloon dilation is an effective treatment and results in sustained improvement in people suffering from refractory gastroparesis.

The study aimed to examine the efficacy and safety of endoscopic pyloric dilation in gastroparesis patients, confirmed by gastric emptying scintigraphy.

In this retrospective analysis, participants (n=47) suffering from refractory gastroparesis were recruited and treated with endoscopic pyloric dilation. The efficacy of the technique estimated at 2 and 6 months with the Gastric Cardinal Symptom Index (GCSI) was the major endpoint ascertained.

At 2 months, 53% of patients (n=25) and at 6 months, 40% of patients (n=19) exhibited a clinical response that was defined by a 1.0 point reduction in GCSI score. Compared to the preoperative score, a substantial reduction in GCSI score at 2 and 6 months was observed. No complications were reported. At 1 year, 9 participants had a delayed relapse.

As found, a second dilation was carried out for 8 participants and was found to be effective in 5 participants. Notably, 27.0 ± 10.4 months was the mean follow-up time of the volunteers. Following this treatment, 15 participants (32%) still experienced betterment. There was no predictive factor of clinical response.

In refractory gastroparesis patients, the efficacy of pyloric dilation was 53% at 2 months, with sustained improvement in one-third of patients at two years. Thus, endoscopic pyloric balloon dilation can be deemed as a substitute for pyloromyotomy.