Long Term Follow up of Endoscopic Sclerotherapy for Dilated Gastrojejunostomy after Gastric Bypass

Magdy Giurgius, MD, Nicole Fearing, MD, Alexandra Weir, BA, Lada Micheas, MS, Archana Ramaswamy, MD

University of Missouri

Introduction
Endoscopic sclerotherapy with sodium morrhuate has been used to treat patients with weight regain following Roux-en –Y Gastric Bypass with the presumed etiology of loss of restriction due to gastrojejunostomy dilation. Weight loss and stability have been demonstrated in several studies with short term follow up, though no long term results have been reported.

Methods
A retrospective review of all patients who underwent sclerotherapy for a dilated gastrojejunostomy between 2007 and 2012 was performed.

Results
Forty-eight patients were identified with a median follow up of 22 months (12-60 months). The median age was 42.5 years (range: 22-63 years) and 92% were female. The original gastric bypass procedures were performed between 1991 and 2007. Average weight loss from the primary procedure was 120 pounds (lbs.) (range: 65-273 lbs.). Median weight regain from lowest weight to maximum weight prior to sclerotherapy was 34 lbs. (range: 0-227 lbs.). The median time between initial surgery and sclerotherapy was 8.5 years (range: 2-15 years). Patients underwent a median of 2.5 sclerotherapy sessions (range: 1 – 4). Preprocedure measured median gastrojejunostomy diameter was 25 mm (range: 15-35 mm). Median volume of sodium morrhuate injected was 12.5 ml per session (range: 3-22 ml). 56.2% patients had 1 year or more of follow up, 39.5% had 2 years or more of follow up, and 15% had 4 or more years of follow up. Median weight loss from sclerotherapy to final documented weight was 9.5 lbs., with a range of 53 lbs. lost to 34 lbs. gained. This was not a statistically significant value. The outcomes remained unchanged on multivariate analysis even when controlling for volume of sodium morrhuate injected, patient age, gastrojejunostomy diameter, number of sclerotherapy sessions and number of years of follow-up.

Conclusion
At long term follow-up of patients undergoing sclerotherapy of the gastrojejunostomy for weight gain following gastric bypass, there is only a marginal weight loss which was not statistically significant in our study population.


Session: Podium Presentation

Program Number: S051

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