{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T15:26:30Z","timestamp":1790436390221,"version":"4.1.0"},"reference-count":21,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2018,8,15]],"date-time":"2018-08-15T00:00:00Z","timestamp":1534291200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100007687","name":"Svenska L\u00e4kares\u00e4llskapet","doi-asserted-by":"publisher","award":["SLS\u2010590821"],"award-info":[{"award-number":["SLS\u2010590821"]}],"id":[{"id":"10.13039\/501100007687","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Perforated duodenal ulcers can be treated with a covered stent. Stent migration is a severe complication, sometimes requiring surgery. Pyloric physiology during stent treatment has not been studied and mechanisms for migration are unknown. The aim of this study was to investigate the pyloric response to distention, mimicking stent treatment, using the EndoFLIP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A nonsurvival study in five pigs was carried out, followed by a pilot study in one volunteer. Animals were gastroscoped during anaesthesia and the EndoFLIP was placed straddling the pylorus. Baseline distensibility readings were performed at stepwise balloon distentions to 20, 30, 40, and 50\u00a0mL, measuring pyloric cross\u2010sectional area and pressure. Measurements were repeated after administration of a prokinetic drug and after a liquid meal. In the human study, readings were performed in conscious sedation at baseline and after stimulation with metoclopramide.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>During baseline readings, the pylorus was shown to open more with increasing distention together with higher amplitude motility waves. Reaching maximum distention\u2010volume (50\u00a0mL), pyloric pressure increased significantly (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.016), and motility waves disappeared. After prokinetic stimulation, the pressure decreased and the motility waves increased in frequency and amplitude. After food stimulation, the pressure stayed low and the motility showed increase in amplitude. During both tests, the pylorus showed higher pressure and lack of motility waves at maximum probe distention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>The pylorus seems to act as a sphincter at low distention but when further dilated starts acting as a pump. Fully distended the pyloric motility disappears and the pressure remains high, suggesting that a stent with high\u2010radial force might show less migration.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13445","type":"journal-article","created":{"date-parts":[[2018,8,15]],"date-time":"2018-08-15T10:39:28Z","timestamp":1534329568000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Exploring pyloric dynamics in stenting using a distensibility technique"],"prefix":"10.1111","volume":"30","author":[{"given":"Jorge Alberto","family":"Arroyo V\u00e1zquez","sequence":"first","affiliation":[{"name":"Department of Surgery South \u00c4lvsborg Hospital Bor\u00e5s Sweden"},{"name":"Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0529-4998","authenticated-orcid":false,"given":"Maria","family":"Bergstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Surgery South \u00c4lvsborg Hospital Bor\u00e5s Sweden"},{"name":"Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Bligh","sequence":"additional","affiliation":[{"name":"Department of Medical Physics &amp; Clinical Engineering, Tallaght Hospital and TAGG Research Centre, School of Medicine Trinity College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barry P.","family":"McMahon","sequence":"additional","affiliation":[{"name":"Department of Medical Physics &amp; Clinical Engineering, Tallaght Hospital and TAGG Research Centre, School of Medicine Trinity College Dublin Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per\u2010Ola","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Surgery South \u00c4lvsborg Hospital Bor\u00e5s Sweden"},{"name":"Gothenburg University Gothenburg Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,8,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.01.011"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-2050.2005.00476.x"},{"key":"e_1_2_10_4_1","first-page":"222","article-title":"Self\u2010expandable metal stents as a new treatment option for perforated duodenal ulcer","volume":"45","author":"Bergstrom M","year":"2013","journal-title":"Endoscopy"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i37.6199"},{"key":"e_1_2_10_6_1","first-page":"158","article-title":"High proximal migration rate of a partially covered \"big cup\" duodenal stent in patients with malignant gastric outlet obstruction","volume":"46","author":"Berg MW","year":"2014","journal-title":"Endoscopy"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2982.1998.00098.x"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(73)80092-7"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.15.144"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-015-1087-7"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12028"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12041"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2016.454"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13053"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12522"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12772"},{"key":"e_1_2_10_17_1","article-title":"Pyloric sphincter characteristics using EndoFLIP((R)) in gastroparesis","author":"Saadi M","year":"2018","journal-title":"Rev Gastroenterol Mex"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200262180-00004"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.autneu.2010.10.006"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-013-3121-2"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.4.5632.679"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.23.2.150"}],"container-title":["Neurogastroenterology &amp; 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