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

Authors

  • Lea Fayad

    1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States
  • Arvind J. Trindade

    2   Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York, United States
  • Petros C. Benias

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

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

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

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

    1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States
  • Olaya I. Brewer Gutierrez

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

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

    1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States
  • Anthony N. Kalloo

    1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States
  • Mouen A. Khashab

    1   Division of Gastroenterology and Hepatology, Johns Hopkins Medical Institution, Baltimore, Maryland, United States
  • Christopher C. Thompson

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

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

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



Publication History

Received: 04 April 2019

Accepted: 28 November 2019

Article published online:
23 January 2020

© Georg Thieme Verlag KG
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