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- Title
Correlation Between Gastrojejunal Anastomosis Diameter, Distensibility Index, and Weight Regain After Roux-en-Y Gastric Bypass.
- Authors
Razzak, Farah Abdul; Kerbage, Anthony; Brunaldi, Vitor O.; Mrad, Rudy; Mahmoud, Tala; Gala, Khushboo; Vargas, Eric J.; Storm, Andrew; Ghanem, Omar; Dayyeh, Barham Abu
- Abstract
Introduction: Gastrojejunal anastomosis (GJA) dilation is an independent predictor of weight regain (WR) after Roux-en-Y gastric bypass (RYGB). However, the role of planimetric measurements in this context remains unknown. Methods: This is a retrospective cohort study including adult RYGB patients who underwent a diagnostic endoscopy with Endoflip assessment of the GJA. We excluded patients in the early postoperative period and those with abnormal endoscopic findings (marginal ulcers and gastro-gastric fistulas). Results: Thirty-four patients were initially included. Endoscopic GJA diameter had a moderate positive correlation with WR (r=+0.438, p=0.011). However, after excluding the 7 patients with GJA> 30 mm, there was no significant correlation. There was a moderate agreement between the EndoFLIP-GJA diameter at 60mL and endoscopic diameter (ICC=0.576, p=0.049). The distensibility index (DI) showed a consistent moderate negative correlation with WR. Considering the maximum DI at 40 ml, we found a cutoff of DI = 7 mm2/mmHg that split the sample in two significantly different populations in terms of WR (67.4% vs. 43.2%, p=0.04). Conclusion: Visual estimation of the GJA diameter correlates with EndoFLIP at 60mL. In the subset of patients with GJA ≤ 30 mm, more distensible GJAs are associated with lower rates of WR. Larger studies are needed to confirm this correlation and to validate its utility for clinical management.
- Subjects
GASTRIC bypass; SURGICAL anastomosis; DIAMETER; POSTOPERATIVE period
- Publication
Obesity Surgery, 2023, Vol 33, Issue 12, p4042
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-023-06918-3