ArticleDigestive diseases and sciences2021
EndoFLIP and Pyloric Dilation for Gastroparesis Symptoms Refractory to Pyloromyotomy/Pyloroplasty.
Article in Digestive diseases and sciences, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 37 citations in OpenAlex.
- Gastric per-oral endoscopic myotomy versus pyloric injection of botulinum toxin for the treatment of gastroparesis: our institutional experience and a systematic review of the literature.Surgical endoscopy · 2023Pooled it
- SAGES-EAES systematic review and meta-analysis for the use of FLIP/impedance planimetry in the surgical work-up and management of GERD, achalasia, and gastroparesis.Surgical endoscopy · 2026Article
- EndoFLIP Guided Assessment of Pyloric Distensibility Identifies Associations With Delayed Gastric Emptying and Symptoms of Gastroparesis.Neurogastroenterology and motility · 2026Article
- Use of Endoflip - Impedance Planimetry System: For Which Indications?Visceral medicine · 2025Review
- Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment.Gut and liver · 2025Review
- Invited Commentary: Gastrointestinal Transit Scintigraphy: Adherence to Current Imaging Standards and Future Directions.Radiographics : a review publication of the Radiological Society of North America, Inc · 2024Article
- Use of endolumenal functional lumen imaging probe in investigating paediatric gastrointestinal motility disorders.World journal of clinical pediatrics · 2023Review
- Targeting the pylorus in gastroparesis: From physiology to endoscopic pyloromyotomy.Neurogastroenterology and motility · 2023Review
- Endoscopic findings do not predict per-oral pyloromyotomy (POP) response.Surgical endoscopy · 2023Article
- A New Paradigm Shift in Gastroparesis Management.Gut and liver · 2022Review
- Efficacy and safety of endoscopic pyloric balloon dilation in patients with refractory gastroparesis.Surgical endoscopy · 2022Article
- Fasting pyloric diameter and distensibility by functional endoluminal imaging probe in unsedated healthy volunteers.Neurogastroenterology and motility · 2022Article
- Endoscopic treatment modalities for the management of gastroparesis: a critical review.Annals of gastroenterologyReview
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundGastroparesis patients may undergo pyloromyotomy/pyloroplasty for chronic refractory symptoms. However, some patients have persistent symptoms. It is unknown if balloon dilation may improve their symptoms.
aimsWe aimed to (1) assess if pyloric through-the-scope (TTS) balloon dilation results in symptom improvement in gastroparesis patients with suboptimal response to pyloromyotomy/pyloroplasty and (2) determine endoscopic functional luminal imaging probe (EndoFLIP) characteristics of these patients before dilation.
methodsPatients with severe gastroparesis refractory to pyloromyotomy/pyloroplasty seen from 2/2019 to 3/2020 underwent pyloric TTS dilation after assessing the pyloric characteristics using EndoFLIP. Patients completed Gastroparesis Cardinal Symptom Index (GCSI) pre-procedurally, and GCSI and Clinical Patient Grading Assessment Scale (CPGAS) on follow-ups.
resultsThirteen (ten females) patients (mean age 45.2 ± 5.1 years) with severe gastroparesis symptoms (mean GCSI total score 3.4 ± 0.3) after pyloromyotomy/pyloroplasty underwent pyloric TTS dilation. Overall, there was improvement in symptoms at 1-month follow-up (mean GCSI total score 3.0 ± 0.4, mean CPGAS score 1.6 ± 0.5, p < 0.05 for both), with five (38%) patients reporting symptoms somewhat/moderately better. The patients with symptom improvement had lower pre-dilation pyloric EndoFLIP distensibility at 30 ml, 40 ml, and 50 ml than patients with little/no improvement (all p < 0.05).
conclusionsIn gastroparesis patients with refractory symptoms after pyloromyotomy/pyloroplasty, pyloric TTS dilation improved symptoms in about a third of the patients. Patients with symptom improvement had lower pre-dilation pyloric distensibility on EndoFLIP suggesting incomplete myotomy, pyloric muscle regeneration, or pyloric stricture. Pyloric EndoFLIP followed by TTS dilation seems to be a promising treatment for some patients with gastroparesis symptoms refractory to pyloromyotomy/pyloroplasty.
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