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

L. Fayad
C. Simsek
D. Badurdeen
C. Hill
O. I. Brewer Gutierrez
G. Fayad
M. Dunlap
A. N. Kalloo
M. A. Khashab
M. Canto
V. Kumbhari
A. J. Trindade, Zucker School of Medicine at Hofstra/Northwell
P. C. Benias, Zucker School of Medicine at Hofstra/Northwell
M. Raad
C. C. Thompson

Abstract

© 2020 Georg Thieme Verlag. All rights reserved. Background â 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 â A retrospective chart review (JanuaryâŠ-âŠNovember 2018) at two academic centers identified patients with weight regain post-RYGB, treated with cryoablation if pouch >âŠ4âŠcm and/or outlet >âŠ15âŠmm. Patients were scheduled for surveillance endoscopies at 8 weeks. Results â22 patients presented 10.5 years (SD 4.42) post-RYGB with weight regain of 30.9âŠkg (SD 13.7). Technical success was 89.5âŠ% for outlet ablation and 93.0âŠ% for pouch ablation. From baseline to 8 weeks, the outlet was reduced from 24.1âŠmm (95âŠ% confidence interval [CI] 19.8 to 28.5) to 17.1âŠmm (95âŠ%CI 13.1 to 21.1; P âŠ<âŠ0.001), and pouch from 5âŠcm (95âŠ%CI 4.1 to 5.9) to 3.9âŠcm (95âŠ%CI 2.6 to 5.1; P âŠ<âŠ0.05). Total body weight loss at 8 weeks was 8.1âŠ% (SD 12.8âŠ%). Conclusion â Cryoablation appears technically feasible and effective for outlet and/or pouch reduction in the short term.