A technical surgery for refractory gastroparesis in a patient with a mitochondrial disorder.

Gastroparesis is a symptomatic chronic disorder of the stomach characterized by delayed gastric emptying in the absence of mechanical obstruction. Gastroparesis has been associated with various diseases and may occur as part of a mitochondrial disorder. In a patient with pyruvate dehydrogenase complex deficiency, which is associated with abnormal mitochondrial metabolism, intragastric liquids were retained massively and gastroparesis was diagnosed by demonstrating delayed gastric emptying. For an atonic stomach with impaired fundic distention, partial gastric plication, modified stomach-partitioning gastrojejunostomy using the stapled gastrectomy with Braun's anastomosis, antireflux gastroplasty with stapled wedge, and re-gastrostomy were performed. After operation, intragastric liquids were reduced remarkably and delayed gastric emptying was improved. She was doing well and discharged uneventfully. Our technical surgery reported improvement in delayed gastric emptying and we confirm the benefits of this operation.