Can Gastric Stimulation in an Animal Model Effect Duodenal and Sphincter of Odi Electrical Activity? a Pilot Study Utilizing Ancillary High Resolution Recordings Thomas L. Abell*, Benjamin T. Boatright, Brittain F. Heindl, Sumanth Daram, Simon H. Bull, Zeke Pullan, Archana Kedar, Pierre De Delva, Christopher J. Lahr, Warren Starkebaum, Peng Du, Leo K. Cheng Digestive Diseases, University of Louisville Medical Center, Louisville, KY; Digestive Diseases, University of Mississippi Medical Center, Jackson, MS; Surgery, University of Mississippi Medical Center, Jackson, MS; Medicine, University of Alabama Birmingham, Birminham, AL; Bioengineering, University of Auckland, Auckland, New Zealand; Consultant Engineer, Plymouth, MN Introduction: Many patients with the symptoms of gastroparesis (Gp), who have known electro-mechanical dysfunction, also have concomitant biliary symptoms. Although the mechanism remains unknown, abnormalities similar to those seen with gastric electrical function might also exist in the biliary tree. We utilized an animal model to investigate a possible connection between gastric and biliary electrical activity utilizing stimulation of the stomach while measuring simultaneous biliary electrical activity. High resolution recordings of electrical activity are a new technology that has not been widely used, especially regarding neural stimulation of the gut. Methods: Utilizing three pigs as the model, the stomach was stimulated with 3 electrical energies, labeled as low, medium and high, and simultaneously recorded the evoked response of electrical activity in the biliary tree, via electrodes in the sphincter of Oddi and duodenal regions. Using this model with electrodes attached surgically, the three energies (as energy/pulse in micro-jules) utilized the following settings: Low (5 mA of current, Pulse Width (PW) 330 microseconds, 14 Hz, 0.1 s on and 5 s off), Medium (10 mA of current, PW 330 microseconds, 28 Hz, 1.0 s on and 4.0 s off) and High (20 mA, PW 450 microseconds, 55 Hz, 4 s on and 1.0 s off). Sphincter of Oddi and duodenal electrical activities were recorded and analyzed by signal averaging for frequency (in cpm), amplitude (in mV) and frequency to amplitude ratio (FAR). In addition, high resolution mapping using a multi-electrode array recorded electrical activity in adjacent areas. Descriptive statistics, including comparisons with energies used, were performed and reported as mean values. Results: Using the model and methods above, delivery of low, medium and high energies via the stomach resulted in changes in frequency and amplitude in the biliary tree with the most optimal values (by lowest FAR) after stimulation being at the highest energies (see table one). Simultaneous high resolution recordings were also recorded and baseline frequncies were similar (10.0 cpm for signal averaging and 9.8 cpm for high resolution recordings.) Conclusions: Gastric stimulation in an animal model appears to effect biliary (sphincter of Oddi and duodenal) electrical activity. Simultaneous high resolution electrical recordings also are feasible and may be applied to this model.This data suggests the existence of intrinsic neural connections that could have potential for therapeutic use in patients with Gp and biliary dyskinesia.