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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
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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Referred to by:

Author commentary on Lea Fayad et al.Endoscopy 2020; 52(03): v8-v8
DOI: 10.1055/a-1089-6954

Referred to by:

Endoscopic revision of bariatric surgery: expanding the toolboxEndoscopy 2020; 52(03): 166-167
DOI: 10.1055/a-1098-3879

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
Stuttgart · New York

 

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