Pyloric Functional Lumen Imaging Probe Measurements Are Dependent on Balloon Position

Brandon Yim; Lennon Gregor; Robert M Siwiec; Mohammad Al-Haddad; Thomas V Nowak; John M Wo

doi:10.5056/jnm22053

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저자정보: Brandon Yim (Division of Gastroenterology and Hepatology University of Hawaii Honolulu HI USA) Lennon Gregor (Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA) Robert M Siwiec (Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA) Mohammad Al-Haddad (Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA) Thomas V Nowak (Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA) John M Wo (Division of Gastroenterology and Hepatology Indiana University School of Medicine Indianapolis IN USA)

저널정보: 대한소화관운동학회(현 대한소화기능성질환.운동학회) Journal of Neurogastroenterology and Motility (JNM) Journal of Neurogastroenterology and Motility (JNM) Vol.29 No.2

발행연도: 2023.4

수록면: 192 - 199 (8page)

DOI: 10.5056/jnm22053

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Background/AimsThe functional lumen imaging probe (FLIP) device has been used to assess pyloric dysfunction in patients with gastroparesis. We aim to investigate whether varying FLIP catheter positions affect pyloric FLIP measurements. MethodsPatients undergoing endoscopy for chronic unexplained nausea and vomiting (CUNV) or gastroparesis were prospectively enrolled. FLIP balloon was adjusted for 3 positions within the pylorus: (1) proximal position, 75% of FLIP balloon in the duodenum and 25% in the antrum; (2) middle position, 50% in the duodenum and 50% in the antrum; and (3) distal position, 25% in the duodenum and 75% in the antrum. Pylorus cross-sectional area (CSA), intra-bag pressure (P), and distensibility indices (DI) were measured for 30, 40, and 50-mL balloon volumes. Fluoroscopic images were obtained to confirm FLIP balloon geometry. Data was analyzed separately using FLIP Analytic and customized MATLAB software. ResultsTwenty-two patients with CUNV (n = 4) and gastroparesis (n = 18) were enrolled. Pressures were significantly higher in the proximal position compared to the middle and distal positions. CSA measurements were significantly higher at the proximal and middle positions for 30-mL and 40-mL volume compared to the distal position values. DI values were significantly lower at the proximal positions for 40-mL and 50-mL distensions when compared to the middle and distal positions. Fluoroscopic images confirmed increased balloon bending when placed mostly in the duodenum. ConclusionsFLIP balloon position within the pylorus directly affects balloon geometry which significantly affects P, CSA, and DI measurements. Standardized pyloric FLIP protocols and balloon design adjustments are needed for the continued application of this technology to the pylorus.

#EndoFLIP #Gastroparesis #Impedance planimetry #Pylorus

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Brandon Yim

소속기관 Division of Gastroenterology and Hepatology University of Hawaii Honolulu HI USA

주요연구분야 의약학 > 임상의학 > 내과학

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Lennon Gregor