Treatment of Refractory Gastroparesis With Laparoscopic Sleeve Gastrectomy and Pyloroplasty Leading to Symptom Improvement and Increased Gastric Emptying: First Clinical Experience in a Canadian Center

ABSTRACT Laparoscopic sleeve gastrectomy (LSG) and pyloroplasty have been identified as treatment options for gastroparesis refractory to dietary, medical, gastric electrical stimulation, and advanced endoscopic therapies (ie, gastric peroral endoscopic myotomy). This case outlines the management of refractory idiopathic gastroparesis in a 62-year-old man who underwent LSG and pyloroplasty with successful improvements in patient-reported symptoms, gastric emptying rate, and weight gain. This is the first reported case of combined LSG and pyloroplasty being used to treat refractory gastroparesis in a Canadian center and adds to a growing body of evidence that LSG and pyloroplasty can be efficacious for refractory gastroparesis.