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Obesity Surgery

, Volume 25, Issue 1, pp 72–79 | Cite as

Argon Plasma Coagulation of Gastrojejunal Anastomosis for Weight Regain After Gastric Bypass

  • Giorgio A. P. Baretta
  • Helga C. A. W. Alhinho
  • Jorge Eduardo F. Matias
  • João Batista Marchesini
  • João Henrique F. de Lima
  • Celso Empinotti
  • Josemberg M. Campos
Original Contributions

Abstract

Background

The failure of approximately 20 % of obese patients who undergo Roux-en-Y gastric bypass (RYGB) to maintain weight loss over the following 18–24 months is related to the surgical procedure, to the patient, or both. Although the underlying mechanisms are uncertain, one factor that has been postulated is the dilation of the gastrojejunal anastomosis. The objective was to evaluate the safety and efficacy of the serial use of argon plasma coagulation (APC) in reducing the diameter of the dilated gastrojejunal anastomosis and post-RYGB weight regain.

Methods

We carried out a prospective, nonrandomized study of 30 patients, with no control or sham group, monitoring RYGB weight regain associated with dilation of the gastrojejunal anastomosis over a postoperative period of 18 months. Each patient underwent three sessions of APC in the anastomosis separated by 8 weeks, with a final endoscopic examination 8 weeks after the last session.

Results

There was a loss of 15.48 kg (range = 8.0–16.0 kg) of the 19.6 kg (range = 7.0–39.0 kg) of regained weight after RYGB and a reduction of 66.89 % in the final anastomotic diameter, with statistically significant reductions between each APC session. Previous body mass index significantly decreased up to the final examination, and the final weight was close to but not at the same level as the nadir.

Conclusions

Our study indicates that the use of APC to treat weight regain after RYGB is a safe and effective procedure and promotes a reduction in gastrojejunal anastomosis, final weight, and BMI, with a low rate of complications.

Keywords

Bariatric surgery Roux-en-Y gastric bypass Weight regain Argon plasma coagulation Bariatric endoscopy 

Notes

Conflict of Interest

All authors declare no disclosures.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Giorgio A. P. Baretta
    • 1
  • Helga C. A. W. Alhinho
    • 2
  • Jorge Eduardo F. Matias
    • 1
  • João Batista Marchesini
    • 1
  • João Henrique F. de Lima
    • 1
  • Celso Empinotti
    • 3
  • Josemberg M. Campos
    • 2
  1. 1.Universidade Federal do ParanáCuritibaBrazil
  2. 2.Departamento de CirurgiaUniversidade Federal de PernambucoRecifeBrazil
  3. 3.Departamento de CirurgiaUniversidade Federal de Santa CatarinaFlorianópolisBrazil

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