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R. Soc. Interface."],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n                    Pyloric interventions are surgical procedures employed to increase the gastric emptying rate in gastroparesis patients. In this study, we use an\n                    <jats:italic>in silico<\/jats:italic>\n                    model to investigate the consequences of pyloric intervention on gastric flow and emptying for two phenotypes of gastroparesis: antral hypomotility and decreased gastric tone. The transpyloric pressure gradient predicted by the\n                    <jats:italic>in silico<\/jats:italic>\n                    model, based on viscous fluid flow equations, is compared against\n                    <jats:italic>in vivo<\/jats:italic>\n                    measurements. Both phenotypes exhibit a similar pre-procedural emptying rate reduction, but after pyloric surgery, antral hypomotility case with preserved gastric tone shows significant improvements in emptying rates, up to 131%, accompanied by bile reflux from the duodenum into the stomach. Conversely, severely reduced gastric tone cases exhibited a post-procedural reduction in the net emptying rate due to the relatively larger bile reflux. In cases with a combination of antral hypomotility and reduced gastric tone, post-procedural improvements were observed only when both conditions were mild. Our findings highlight the pivotal role of the relative increase in pyloric orifice diameter in determining post-operative emptying rates. The study suggests a possible explanation for the selective response of patients toward these procedures and underscores the potential of\n                    <jats:italic>in silico<\/jats:italic>\n                    modelling to generate valuable insights to inform gastric surgery.\n                  <\/jats:p>","DOI":"10.1098\/rsif.2023.0567","type":"journal-article","created":{"date-parts":[[2024,1,24]],"date-time":"2024-01-24T03:06:15Z","timestamp":1706065575000},"update-policy":"https:\/\/doi.org\/10.1098\/crossmark-policy","source":"Crossref","is-referenced-by-count":20,"title":["<i>In<\/i>\n                    <i>silico<\/i>\n                    modelling of the effect of pyloric intervention procedures on gastric flow and emptying in a stomach with gastroparesis"],"prefix":"10.1098","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-7994","authenticated-orcid":true,"given":"Sharun","family":"Kuhar","sequence":"first","affiliation":[{"name":"Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5534-2508","authenticated-orcid":false,"given":"Jung-Hee","family":"Seo","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pankaj J","family":"Pasricha","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Phoenix, AZ 85054, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8107-9499","authenticated-orcid":false,"given":"Rajat","family":"Mittal","sequence":"additional","affiliation":[{"name":"Department of Mechanical Engineering, Johns Hopkins University, Baltimore, MD 21218, USA"},{"name":"Department of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"175","published-online":{"date-parts":[[2024,1,24]]},"reference":[{"key":"e_1_3_8_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2006.02.002"},{"key":"e_1_3_8_3_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.1980.239.2.G71"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00257543"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0115426505020005517"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001874"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.1203"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-326904"},{"key":"e_1_3_8_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2019-318712"},{"key":"e_1_3_8_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.373"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v23.i24.4428"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-017-4456-7"},{"key":"e_1_3_8_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/000313481508100726"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14494"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.01.044"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.12.033"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-019-07135-9"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2006.10.018"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-018-6342-6"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-0812-1458"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-011-1607-6"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800711011"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.3109\/00365529009107938"},{"key":"e_1_3_8_24_2","doi-asserted-by":"crossref","unstructured":"Roses RE Fraker DL. 2015 Bile reflux and gastroparesis. 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