{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:40:22Z","timestamp":1792644022130,"version":"4.5.0"},"reference-count":39,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,10]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n Gastroparesis (GP) is a motility disorder characterized by pronounced delayed gastric emptying and associated with symptoms. Endoscopic pyloric dilation (PyD) is a minimally invasive option targeting pyloric dysfunction, though efficacy remains variably reported.<\/jats:p>\n <\/jats:sec>\n \n Aims<\/jats:title>\n This systematic review assessed clinical outcomes and safety of PyD in adults and children with GP not associated with surgical manipulation.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n PubMed, Embase, and Scopus were searched through December 2025 for studies evaluating PyD in GP. Post\u2010surgical and non\u2010GP etiologies were excluded. Twelve studies (12 full manuscripts) met inclusion criteria. Data on technique, response rates, and adverse events were extracted.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Quality of studies was fair to poor. Symptom improvement with PyD was described in 37%\u201385% of treated patients. PyD plus botulin toxin efficacy was reported as 50%\u201380%. Benefits were reported as early as 2\u2009weeks and up to 2\u2009years after intervention. Repeat dilations were occasionally performed with response ranging from 40% to 95% for adults and children. No serious complications were reported. Adverse events were limited to transient pain reported in one study. Variability in technique and outcome definitions limited pooled analyses.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Within study quality constraints, PyD may be a low\u2010risk option for symptom relief in select GP patients across all age groups. As there was significant heterogeneity in the data published, well\u2010designed control studies should be performed to evaluate if this efficacy is convincing. Standardized protocols and integration of novel tools such as EndoFLIP are needed to refine patient selection and assess long\u2010term efficacy.<\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.70436","type":"journal-article","created":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:19:39Z","timestamp":1792642779000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Systematic Review: Role of Pyloric Dilation in the Management of Gastroparesis"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7129-3640","authenticated-orcid":false,"given":"Milli","family":"Gupta","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology University of Calgary Calgary Alberta Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0179-8929","authenticated-orcid":false,"given":"Alberto","family":"Barchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Gastrointestinal Endoscopy IRCCS San Raffaele Hospital Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert J.","family":"Bredenoord","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Academisch Medisch Centrum Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2839-027X","authenticated-orcid":false,"given":"Gwen M. C.","family":"Masclee","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Academisch Medisch Centrum Amsterdam the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"issue":"8","key":"e_1_2_10_2_1","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.14309\/ajg.0000000000001874","article-title":"ACG Clinical Guideline: Gastroparesis","volume":"117","author":"Camilleri M.","year":"2022","journal-title":"American Journal of Gastroenterology"},{"issue":"3","key":"e_1_2_10_3_1","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1002\/ueg2.12060","article-title":"United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) Consensus on Gastroparesis","volume":"9","author":"Schol J.","year":"2021","journal-title":"United European Gastroenterology Journal"},{"issue":"6","key":"e_1_2_10_4_1","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1055\/a-1160-5549","article-title":"Endoscopic Management of Gastrointestinal Motility Disorders\u2010Part 1: European Society of Gastrointestinal Endoscopy (ESGE) Guideline","volume":"52","author":"Weusten B.","year":"2020","journal-title":"Endoscopy"},{"issue":"5","key":"e_1_2_10_5_1","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1053\/j.gastro.2025.08.004","article-title":"AGA Clinical Practice Guideline on Management of Gastroparesis","volume":"169","author":"Staller K.","year":"2025","journal-title":"Gastroenterology"},{"issue":"4","key":"e_1_2_10_6_1","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1016\/j.athoracsur.2010.12.055","article-title":"Management of Delayed Gastric Emptying After Esophagectomy With Endoscopic Balloon Dilatation of the Pylorus","volume":"91","author":"Lanuti M.","year":"2011","journal-title":"Annals of Thoracic Surgery"},{"issue":"6","key":"e_1_2_10_7_1","doi-asserted-by":"crossref","first-page":"1919","DOI":"10.1016\/0016-5085(86)90262-3","article-title":"Pyloric Dysfunction in Diabetics With Recurrent Nausea and Vomiting","volume":"90","author":"Mearin F.","year":"1986","journal-title":"Gastroenterology"},{"issue":"11","key":"e_1_2_10_8_1","doi-asserted-by":"crossref","first-page":"2170","DOI":"10.1136\/gutjnl-2022-326904","article-title":"Endoscopic Pyloromyotomy for the Treatment of Severe and Refractory Gastroparesis: A Pilot, Randomised, Sham\u2010Controlled Trial","volume":"71","author":"Martinek J.","year":"2022","journal-title":"Gut"},{"issue":"10","key":"e_1_2_10_9_1","doi-asserted-by":"crossref","first-page":"2405","DOI":"10.1007\/s00268-016-3575-1","article-title":"Gastric Outlet Obstruction After Esophagectomy: Retrospective Analysis of the Effectiveness and Safety of Postoperative Endoscopic Pyloric Dilatation","volume":"40","author":"Maus M. 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