Landreneau JP, et al. - As patients with severe, refractory symptoms of gastroparesis may ultimately be managed with Roux-en-Y reconstruction, researchers here examined if the stomach should be left in situ, similar to a conventional gastric bypass, or resected as in gastrectomy. They retrospectively reviewed 26 patients who underwent Roux-en-Y with stomach left in situ (RY-SIS) and 27 patients who underwent gastrectomy with Roux-en-Y reconstruction during the study period at their institution from September 2010 through March 2018. Outcomes revealed greater perioperative morbidity in association with gastrectomy vs leaving the stomach in situ. At intermediate follow-up, equivalent symptomatic improvement was observed with the two procedure. However, subsequent surgical intervention may be more frequently required in patients undergoing RY-SIS, indicating gastrectomy to be a more definitive operation for the management of medically refractory gastroparesis.