Laura Mazer1, Jessica X Yu2, Sean Bhalla2, Kevin Platt2, Lydia Watts2, Sarah Volk2, Allison R Schulman3,4. 1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. 2. Division of Gastroenterology and Hepatology, University of Michigan, 3912 Taubman Center, 1500 E. Medical Center Dr. SPC 5362, Ann Arbor, MI, USA. 3. Department of Surgery, University of Michigan, Ann Arbor, MI, USA. arschulm@med.umich.edu. 4. Division of Gastroenterology and Hepatology, University of Michigan, 3912 Taubman Center, 1500 E. Medical Center Dr. SPC 5362, Ann Arbor, MI, USA. arschulm@med.umich.edu.
Abstract
BACKGROUND: Gastric sleeve stenosis (GSS) occurs in up to 4% of patients after laparoscopic sleeve gastrectomy (LSG). Typical symptoms include reflux, abdominal pain, dysphagia, and regurgitation. Serial pneumatic balloon dilation (PBD) is a successful treatment in many cases obviating the need for revisional surgery, but the potential for weight regain is unknown. The aim of the current study was to assess weight trends following serial pneumatic dilation for GSS. METHODS: Retrospective analysis of a prospectively maintained database of patients undergoing serial PBD for GSS at one institution. Primary outcome was change in BMI before and after serial PBD. Secondary outcomes included complication rates and need for revisional surgery. Sub-group analyses were performed to determine the relationship of patient and procedural factors to BMI after PBD. RESULTS: Forty-four patients met inclusion criteria, 34 (84.1%) women. Mean age was 46.7 (SD 11.9). Mean pre-sleeve BMI was 47.8 (SD 9.2), and mean BMI prior to first dilation was 34.2 (SD 6.8). Median follow-up was 395 days (range 48-571). Mean BMI at time of last follow up was 33.7 (SD 6.7). There was no statistical difference in BMI pre- or post-PBD (p 0.980). The lowest 10th and highest 90th BMI percentile trended toward a higher and lower BMI after PBD, respectively, though not significant. DISCUSSION: As the prevalence of sleeve gastrectomy continues to rise, an increasing number of patients will require treatment for GSS. Stenosis is effectively treated with serial PBD in most patients without any impact on weight gain, making this an effective and appealing option for many patients.
BACKGROUND: Gastric sleeve stenosis (GSS) occurs in up to 4% of patients after laparoscopic sleeve gastrectomy (LSG). Typical symptoms include reflux, abdominal pain, dysphagia, and regurgitation. Serial pneumatic balloon dilation (PBD) is a successful treatment in many cases obviating the need for revisional surgery, but the potential for weight regain is unknown. The aim of the current study was to assess weight trends following serial pneumatic dilation for GSS. METHODS: Retrospective analysis of a prospectively maintained database of patients undergoing serial PBD for GSS at one institution. Primary outcome was change in BMI before and after serial PBD. Secondary outcomes included complication rates and need for revisional surgery. Sub-group analyses were performed to determine the relationship of patient and procedural factors to BMI after PBD. RESULTS: Forty-four patients met inclusion criteria, 34 (84.1%) women. Mean age was 46.7 (SD 11.9). Mean pre-sleeve BMI was 47.8 (SD 9.2), and mean BMI prior to first dilation was 34.2 (SD 6.8). Median follow-up was 395 days (range 48-571). Mean BMI at time of last follow up was 33.7 (SD 6.7). There was no statistical difference in BMI pre- or post-PBD (p 0.980). The lowest 10th and highest 90th BMI percentile trended toward a higher and lower BMI after PBD, respectively, though not significant. DISCUSSION: As the prevalence of sleeve gastrectomy continues to rise, an increasing number of patients will require treatment for GSS. Stenosis is effectively treated with serial PBD in most patients without any impact on weight gain, making this an effective and appealing option for many patients.
Authors: Amit Parikh; Joshua B Alley; Richard M Peterson; Michael C Harnisch; Jason M Pfluke; Donovan M Tapper; Stephen J Fenton Journal: Surg Endosc Date: 2011-11-02 Impact factor: 4.584
Authors: Michel Gagner; Mervyn Deitel; Traci L Kalberer; Ann L Erickson; Ross D Crosby Journal: Surg Obes Relat Dis Date: 2009-06-13 Impact factor: 4.734
Authors: Richard Welbourn; Marianne Hollyman; Robin Kinsman; John Dixon; Ronald Liem; Johan Ottosson; Almino Ramos; Villy Våge; Salman Al-Sabah; Wendy Brown; Ricardo Cohen; Peter Walton; Jacques Himpens Journal: Obes Surg Date: 2018-11-12 Impact factor: 4.129