Lee Jung Hwan, Kim Chan Gyoo, Kim Young-Woo, Choi Il Ju, Lee Jong Yeul, Cho Soo-Jeong, Kim Young-Il, Eom Bang Wool, Yoon Hong Man, Ryu Keun Won
Center for Gastric Cancer, National Cancer Center, Goyang, Korea.
J Gastric Cancer. 2017 Jun;17(2):173-179. doi: 10.5230/jgc.2017.17.e18. Epub 2017 Jun 13.
To report our experience of endoscopic botulinum toxin injection in patients who experienced severe delayed gastric emptying after pylorus-preserving gastrectomy (PPG).
We reviewed the medical records of 6 patients who received the botulinum toxin injection. They presented with severe delayed gastric emptying in the early postoperative period. Endoscopic botulinum toxin was administered as 4 injections of 25-50 IU into each of the 4 quadrants of the prepyloric area.
All botulinum toxin injections were successful without any complications, enabling 5 patients to tolerate soft solid diets and one to tolerate a soft fluid diet within 10 days. The endoscopic criteria of 4 patients improved. Symptom recurrence caused 2 patients to undergo repeat injections that were successful. The median follow-up period was 27 months, and all patients could ingest normal regular diets at the last follow-up.
Endoscopic botulinum toxin injection is a feasible treatment option for early delayed gastric emptying after PPG.
报告我们对接受保留幽门胃切除术（PPG）后出现严重胃排空延迟患者进行内镜下肉毒杆菌毒素注射的经验。
我们回顾了6例接受肉毒杆菌毒素注射患者的病历。他们在术后早期出现严重胃排空延迟。在内镜下，将肉毒杆菌毒素以每象限25 - 50国际单位的剂量分4次注射到幽门前区域的4个象限。
所有肉毒杆菌毒素注射均成功，无任何并发症，5例患者在10天内能够耐受软固体食物，1例能够耐受软流食。4例患者的内镜检查标准有所改善。症状复发导致2例患者接受重复注射且成功。中位随访期为27个月，所有患者在最后一次随访时都能摄入正常的常规饮食。
内镜下肉毒杆菌毒素注射是PPG术后早期胃排空延迟的一种可行治疗选择。
