Robert Schmieg, Karen Borman, Farshid Araghizadeh, Nighat Abidi, Oscar Batista, Thomas L. Abell, University of Mississippi Medical Center, Jackson, MS

Background: For patients with disordered gastric emptying (DGE), gastric electrical stimulation (GES) can improve symptoms, nutritional status, health resource utilization and costs, and is now approved by the FDA as a humanitarian use device. Temporary GES can be safely and easily performed with endoscopically-placed electrodes, and can aid in preoperative patient evaluation. The efficacy and appropriate duration of tempGES in patients with DGE after gastric surgery has not been previously defined. The present study was conducted to evaluate the efficacy of tempGES in this patient group. Patient Population: 11 patients (8 female, 3 male) with DGE symptoms after gastric surgery (2 Nissen fundoplication, 5 subtotal gastrectomy, 1 pancreaticoduodenectomy, 1 colonic interposition, 2 multiple gastric procedures) were studied. Methods: Each patient underwent tempGES via endoscopically placed electrodes using standard GES parameters. GET was performed before and at the end of 3 days (median) of tempGES by a previously standardized method, and delayed or rapid gastric emptying was identified using standardized definitions (Am J Gastroenterol 95:1456-1462, 2000). DGE symptoms were quantified by patient interview pre- and post-tempGES. (Gastroenterol 125:421-428, 2003) GET results and DGE symptoms before and after tempGES were compared by paired t-tests. Results: GET pre-tempGES was abnormal (5 with rapid emptying with post-operative dumping, 4 with delayed emptying, and 2 unable to tolerate GET meal). After a median of 3 days of tempGES, patients had improved symptoms and GET (see table). TempGES in patients with delayed GET resulted in improved GET with increasing emptying; tempGES in patients with rapid GET resulted in improved GET with slower emptying. Conclusions: In patients with post-surgical DGE, a median of 3 days of tempGES showed a improvement of both symptoms and GET independent of baseline rapid or delayed GET. This safe and easily performed method has potential utility in selecting patients with post-surgical gastric motility disorders who might benefit from GES with a permanent device.