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Pneumatic Balloon Dilation of Gastric Sleeve Stenosis Is Not Associated with Weight Regain

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Abstract

Background

Gastric sleeve stenosis (GSS) occurs in up to 4% of patients after laparoscopic sleeve gastrectomy (LSG). Typical symptoms include reflux, abdominal pain, dysphagia, and regurgitation. Serial pneumatic balloon dilation (PBD) is a successful treatment in many cases obviating the need for revisional surgery, but the potential for weight regain is unknown. The aim of the current study was to assess weight trends following serial pneumatic dilation for GSS.

Methods

Retrospective analysis of a prospectively maintained database of patients undergoing serial PBD for GSS at one institution. Primary outcome was change in BMI before and after serial PBD. Secondary outcomes included complication rates and need for revisional surgery. Sub-group analyses were performed to determine the relationship of patient and procedural factors to BMI after PBD.

Results

Forty-four patients met inclusion criteria, 34 (84.1%) women. Mean age was 46.7 (SD 11.9). Mean pre-sleeve BMI was 47.8 (SD 9.2), and mean BMI prior to first dilation was 34.2 (SD 6.8). Median follow-up was 395 days (range 48–571). Mean BMI at time of last follow up was 33.7 (SD 6.7). There was no statistical difference in BMI pre- or post-PBD (p 0.980). The lowest 10th and highest 90th BMI percentile trended toward a higher and lower BMI after PBD, respectively, though not significant.

Discussion

As the prevalence of sleeve gastrectomy continues to rise, an increasing number of patients will require treatment for GSS. Stenosis is effectively treated with serial PBD in most patients without any impact on weight gain, making this an effective and appealing option for many patients.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Michigan, Ann Arbor, MI, USA

    Laura Mazer & Allison R. Schulman

  2. Division of Gastroenterology and Hepatology, University of Michigan, 3912 Taubman Center, 1500 E. Medical Center Dr. SPC 5362, Ann Arbor, MI, USA

    Jessica X. Yu, Sean Bhalla, Kevin Platt, Lydia Watts, Sarah Volk & Allison R. Schulman

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  1. Laura Mazer
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  6. Sarah Volk
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Contributions

Study concept and design: LM, JXY, ARS. Acquisition, analysis, or interpretation of data: LM, JXY, LW, SV, ARS. Statistical analysis: JXY, ARS. Drafting of the manuscript: LM, JXY, ARS. Critical revision of the manuscript for important intellectual content: LM, JXY, SB, KP, ARS. Study supervision: ARS.

Corresponding author

Correspondence to Allison R. Schulman.

Ethics declarations

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Statement of Informed Consent

Does not apply.

Conflict of Interest

Laura Mazer, Jessica X Yu, Sean Bhalla, Kevin Platt, Lydia Watts, and Sarah Volk have no conflicts to disclose. Allison R. Schulman is a Consultant for Apollo Endosurgery, Boston Scientific, MicroTech, and Olympus, and receives Research/Grant support from GI Dynamics.

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Key Points

- Gastric sleeve stenosis (GSS) following sleeve gastrectomy most commonly at the incisura and has an increasing prevalence

- Patients frequently present with abdominal pain, nausea/vomiting, dysphagia, or reflux

- Endoscopic pneumatic balloon dilation is emerging as a first-line therapy for GSS that may prevent the need for revisional surgery, but data on weight change is lacking

- Here, we demonstrate that there is no significant change in body mass index (BMI) before and after dilation

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Mazer, L., Yu, J.X., Bhalla, S. et al. Pneumatic Balloon Dilation of Gastric Sleeve Stenosis Is Not Associated with Weight Regain. OBES SURG 32, 1–6 (2022). https://doi.org/10.1007/s11695-022-05957-6

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  • DOI: https://doi.org/10.1007/s11695-022-05957-6

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