A pilot study of the effect of cisapride on gastric emptying in patients with chronic gastroparesis after highly selective vagotomy

In a double-masked, placebo-controlled, crossover study, the effects of cisapride (10 mg three times daily for 2 weeks), a gastroprokinetic drug, were evaluated on the gastric emptying and stasis symptoms of seven patients who had chronic gastroparesis more than 1 year after highly selective vagotomy. The gastric emptying study was conducted using technetium Tc 99m-labeled eggs as the test meal component. Gastric emptying curves and emptying variables (emptying rate, the shape of the emptying curve, half emptying time [t( 1/2 )], and lag time) after cisapride therapy were compared with pretreatment (baseline) values, those after placebo therapy, and those of 17 healthy volunteers (normal controls). Delayed gastric emptying was defined as a t( 1/2 ) > 124 minutes (mean and two SDs of normal controls). The stasis symptom scores after cisapride therapy were also compared with those at baseline and after placebo therapy. Our results showed that cisapride was significantly more effective than placebo in shortening t( 1/2 ) and lag time, and accelerating the emptying rate. After cisapride therapy, gastric emptying was improved in all patients, and it attained a normal range (≤124 minutes) in 5 of 7 patients. The patients' stasis symptoms were significantly improved by cisapride. Cisapride had a better global response than did placebo, but the difference was not statistically significant. We believe cisapride is useful in relieving stasis symptoms and improving gastric emptying for patients with chronic postvagotomy gastroparesis.