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Functional Lumen Imaging Probe Is Useful for the Quantification of Gastric Sleeve Stenosis and Prediction of Response to Endoscopic Dilation: a Pilot Study

Abstract

Background

Stenosis after sleeve gastrectomy (SG) is common though diagnostic criteria and predictors of treatment response is unknown. Endoluminal functional impedance planimetry (EndoFLIP) is a diagnostic tool for measuring lumen geometry. We aimed to use EndoFLIP to characterize SG stenosis.

Methods

We enrolled SG stenosis patients undergoing serial pneumatic dilations between May 2018 and November 2018. Outcomes of interest included pre- and post-dilation EndoFLIP measurements and post-dilation symptom response.

Results

We included 10 patients who underwent a mean of 1.8 ± 0.7 dilations. Pre-dilation EndoFLIP characteristics were similar for responders and non-responders. Responders had larger mean post-dilation diameter (19.9 ± 2.9 mm vs 13.1 ± 1.3 mm, p = 0.007) and DI (21.3 ± 1.0 mm2/Hg vs 4.0 ± 5.4 mm2/Hg, p = 0.04) than non-responders.

Conclusion

Our pilot study supports the use of EndoFLIP in the management of SG stenosis.

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Fig. 1

Abbreviations

DI:

Distensibility index

EndoFLIP:

Endoluminal functional impedance planimetry systems

PBD:

Pneumatic balloon dilation

RYGB:

Roux-en-Y gastric bypass

SG:

Sleeve gastrectomy

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Author information

Study concept and design: JXY, JRB, JWC, JHR, ARS

Acquisition, analysis or interpretation of data: JXY, JRB, LW, ARS

Statistical analysis: JXY, ARS

Drafting of the manuscript: JXY, ARS

Critical revision of the manuscript for important intellectual content: JXY, JRB, OAV, JWC, JHR, ARS

Study supervision: ARS

Correspondence to Allison R. Schulman.

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Conflict of Interest

JXY, LW, JWC, and JHR declare that they have no conflict of interest. JRB is an education consultant in Medtronic GI Solutions. OAV received salary support for leadership and participation in quality improvement initiatives from the Blue Cross Blue Shield of Michigan. ARS is a consultant in Apollo Endosurgery, Boston Scientific, and MicroTech.

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Yu, J.X., Baker, J.R., Watts, L. et al. Functional Lumen Imaging Probe Is Useful for the Quantification of Gastric Sleeve Stenosis and Prediction of Response to Endoscopic Dilation: a Pilot Study. OBES SURG 30, 786–789 (2020). https://doi.org/10.1007/s11695-019-04105-x

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Keywords

  • Bariatrics
  • Sleeve gastrectomy
  • Stenosis
  • Adverse events
  • EndoFLIP