Cryoballoon ablation for gastric pouch and/or outlet reduction in patients with weight regain post Roux-en-Y gastric bypass

Lea Fayad; Arvind J. Trindade; Petros C. Benias; Cem Simsek; Micheal Raad; Dilhana Badurdeen; Christine Hill; Olaya I. Brewer Gutierrez; George Fayad; Margo Dunlap; Anthony N. Kalloo; Mouen A. Khashab; Christopher C. Thompson; Marcia Canto; Vivek Kumbhari

doi:10.1055/a-1086-3433

Endoscopy, Table of Contents

Endoscopy 2020; 52(03): 227-230
DOI: 10.1055/a-1086-3433

Innovations and brief communication

Cryoballoon ablation for gastric pouch and/or outlet reduction in patients with weight regain post Roux-en-Y gastric bypass

Lea Fayad

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Arvind J. Trindade

²Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, United States

,

Petros C. Benias

²Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, United States

,

Cem Simsek

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Micheal Raad

³Division of Surgery, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Dilhana Badurdeen

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Christine Hill

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Olaya I. Brewer Gutierrez

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

George Fayad

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Margo Dunlap

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Anthony N. Kalloo

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Mouen A. Khashab

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Christopher C. Thompson

⁴Division of Gastroenterology, Brigham and Women’s Hospital, Boston, Massachusetts, United States

,

Marcia Canto

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

,

Vivek Kumbhari

¹Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States

› Author Affiliations

Abstract

Background Cryoballoon ablation could induce stricture formation to achieve outlet and pouch reduction in patients regaining weight after Roux-en-Y gastric bypass (RYGB). This pilot study aimed to assess technical feasibility and short-term efficacy.

Methods A retrospective chart review (January – November 2018) at two academic centers identified patients with weight regain post-RYGB, treated with cryoablation if pouch > 4 cm and/or outlet > 15 mm. Patients were scheduled for surveillance endoscopies at 8 weeks.

Results 22 patients presented 10.5 years (SD 4.42) post-RYGB with weight regain of 30.9 kg (SD 13.7). Technical success was 89.5 % for outlet ablation and 93.0 % for pouch ablation. From baseline to 8 weeks, the outlet was reduced from 24.1 mm (95 % confidence interval [CI] 19.8 to 28.5) to 17.1 mm (95 %CI 13.1 to 21.1; P < 0.001), and pouch from 5 cm (95 %CI 4.1 to 5.9) to 3.9 cm (95 %CI 2.6 to 5.1; P < 0.05). Total body weight loss at 8 weeks was 8.1 % (SD 12.8 %).

Conclusion Cryoablation appears technically feasible and effective for outlet and/or pouch reduction in the short term.

Full Text

References

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