Endoscopy 2025; 57(S 02): S268
DOI: 10.1055/s-0045-1805652
Abstracts | ESGE Days 2025
Moderated poster
UGI Diagnostics 05/04/2025, 09:30 – 10:30 Poster Dome 1 (P0)

Functional lumen imaging probe in the functional assessment of pyloric sphincter in gastroparesis: a systematic review with meta-analysis of normative values

Authors

  • A Barchi

    1   Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Scientific Institute, Milan, Italy
    2   Vita-Salute San Raffaele University, Milan, Italy
    3   Department of Gastroenterology & Hepatology, Amsterdam UMC, Amsterdam, Netherlands

  • G Milli

    4   Divisions of Gastroenterology and Hepatology Department of Medicine, University of Calgary, Calgary, Canada

  • N Warringa

    3   Department of Gastroenterology & Hepatology, Amsterdam UMC, Amsterdam, Netherlands

  • F V Mandarino

    1   Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Scientific Institute, Milan, Italy
    2   Vita-Salute San Raffaele University, Milan, Italy

  • E Vespa

    1   Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Scientific Institute, Milan, Italy

  • S Passaretti

    1   Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Scientific Institute, Milan, Italy

  • S Danese

    1   Gastroenterology and Gastrointestinal Endoscopy, IRCCS San Raffaele Scientific Institute, Milan, Italy
    2   Vita-Salute San Raffaele University, Milan, Italy

  • A Bredenoord

    3   Department of Gastroenterology & Hepatology, Amsterdam UMC, Amsterdam, Netherlands

  • G M Masclee

    3   Department of Gastroenterology & Hepatology, Amsterdam UMC, Amsterdam, Netherlands
Further Information
Also available at
 

Aims The selection of the optimal patient to undergo invasive treatments is one of the major challenges in refractory gastroparesis. The aim of this systematic review was to investigate the role of FLIP in gastroparesis. Meta analysis of normative values and treatment comparative outcomes was also performed.

Methods A systematic search was performed until May 2024 on 3 major databases. Studies on post-oncological/bariatric surgery gastroparesis were excluded. Pooled baseline mean of FLIP metrics and mean differences (MDs) pre vs post-treatment were calculated to provide normative values and to assess treatment effect. Random effects meta-analysis with I2 statistics and subgroup analysis to address heterogeneity were performed.

Results Twenty studies (N=805 patients) were included. The majority focused on treatment response, particularly pyloromyotomy (GPOEM). The most assessed FLIP metrics were distensibility index (DI) and cross-sectional area (CSA). Three studies reported a positive correlation between DI and CSA with specific symptoms (dyspepsia spectrum and nausea/vomiting) and their severity at baseline. Ten studies showed an association between FLIP parameters with clinical response but not with gastric emptying. Baseline DI at 30 mL (7.5 mm2/mmHg; I2 38%) and CSA at 30 mL (85.5 mm2; I2 0%) yielded the lowest heterogeneity. Comparing pre- and post-treatment response, MD of 2.5 mm2/mmHg (I2 24%) for DI at 50 mL, 46.7 mm2 (I2 47%) and 68.8 mm2 (I2 0%) for CSA at 40 and 50 mL respectively, resulted statistically significant.

Conclusions This is the first systematic effort in gathering evidence on FLIP in gastroparesis. CSA and DI significantly changed after pylorus-targeted treatments. Normative values displayed substantial heterogeneity. Further studies to develop and validate models of response prediction are warranted before implementing this technique in routine clinical care.



Publication History

Article published online:
27 March 2025

© 2025. European Society of Gastrointestinal Endoscopy. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany