The Effectiveness of Endoscopic Argon Plasma Coagulation (APC) of Dilated Gastrojejunostomy in the Treatment of Weight Regain After Omega Loop Gastric Bypass Surgery
Enas Al Alawi*
Department of Bariatric Surgery, Director of Evidence Based Medicine and Research Center, Novomed Medical Centres, Dubai, UAE
*Corresponding Author: Enas Al Alawi, Department of Bariatric Surgery, Director of Evidence Based Medicine and Research Center, Novomed Medical Centres, Dubai, UAE.
Received:
October 30, 2023; Published: December 27, 2023
Abstract
Background: Omega loop gastric bypass bariatric surgery (OLGB) has shown to be an effective measure for treating morbid obesity and metabolic diseases associated with it, however weight regain few years after surgery poses a major problem as it is accompanied by the return of obesity and the associated metabolic disorders. Surgical revision carries a complication rate leading to morbidity and mortality, there is a demand to find a safe and effective treatment for this problem to avoid revision surgery. One of the main causes of weight regain after OLGB is widening of the gastrojejunostomy anastomosis which connects the gastric pouch to the jejunal loop. Endoscopic Argon Plasma Coagulation (APC) can be used potentially to aid narrowing of the anastomosis leading to weight loss.
Objectives: To study the safety and effectiveness of APC in the treatment of widened gastrojejunostomy anastomosis for patients who regained weight after OLGB.
Methods: A prospective observational study was conducted on a group of twenty patients who underwent APC procedure for dilated gastrojejunostomy with 6 months follow up. Outcome measures included weight loss and complication rate. The results were compared to a matched group of patients (n = 31) who underwent revision surgery for the same reason.
Results: In terms of weight loss and complication rate; the APC group showed a mean weight loss of 10 kgs and a drop of 4 BMI units with no reported complications, whereas, the revision surgery group showed similar results with a mean weight loss of 11 kg and a drop of 4 BMI units. There was 10% complication rate which included 2 cases of anastomotic leak and one case of bowel obstruction secondary to internal herniation.
Conclusion: APC can be safe and effective for treating weight regain after OLGB, although an effective innovative idea however more sample number and longer follow up are needed with well-designed randomized trials to validate the findings.
Keywords: Gastrojejunostomy, Endoscopic Argon Plasma Coagulation
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