Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov;25(6):327-330.
doi: 10.1159/000486561. Epub 2018 Feb 8.

Increased Gastric Retention Capacity, Assessed by Scintigraphy, after APC Treatment of Dilated Gastrojejunal Anastomosis

Sérgio Barrichello  1 , Manoel Dos Passos Galvão Neto  2 , Thiago Ferreira de Souza  1   2 , Eduardo Guimarães Hourmeaux de Moura  1 , Maurício Minata  1 , Ana Paula Oliveira de Quadros  3 , Jaques Waisberg  1 , Eduardo Grecco  2 , Guilherme Macedo  4 , Marco Silva  4 , Luiz Gustavo de Quadros  1
Affiliations

Increased Gastric Retention Capacity, Assessed by Scintigraphy, after APC Treatment of Dilated Gastrojejunal Anastomosis

Sérgio Barrichello et al. GE Port J Gastroenterol. 2018 Nov.

Abstract
in English, Portuguese

Background: Weight regain occurs in about 20% of patients after Roux-en-Y gastric bypass (RYGB). Studies have reported that in most cases this regain is associated with dilatation of the gastrojejunal anastomosis. To correct this dilatation, one of the methods used is the application of argon plasma coagulation (APC).

Case: The authors report the case of a 39-year-old woman submitted to RYGB who had weight regain. In the endoscopic evaluation, the patient presented with dilatation of the gastrojejunal anastomosis, for which treatment with APC and an adjusted diet was proposed. After 3 sessions of APC, the patient presented with a reduction of the anastomosis diameter, weight loss, and increased satiety to food, with an increased gastric emptying time evidenced by scintigraphy.

Conclusion: APC proved to be a safe and efficacious method.

Introdução: O reganho de peso após bypass gástrico em Y de Roux (RYGB) ocorre em cerca de 20% dos doentes. Estudos relatam que na maioria dos casos este reganho está associado a dilatação da anastomose gastrojejunal. Para corrigir esta dilatação um dos métodos utilizados é a apli-cação de árgon plasma (APC).

Caso: Os autores relatam o caso de uma mulher de 39 anos de idade, submetida a RYGB, que apresentou reganho de peso. Na avaliação en-doscópica a doente apresentava dilatação da anastomose gastrojejunal sendo proposta a realização de APC e dieta ajustada. Após 3 sessões de APC, a doente apresentou redução do diâmetro da anastomose associada a perda de peso, aumento da saciedade alimentar e aumento do tempo de esvaziamento gástrico documentado em cintigrafia.

Conclusão: O tratamento com APC mostrou ser um méto-do seguro e eficaz.

Keywords: Bariatric endoscopy; Gastric bypass; Obesity; Roux-en-Y gastric bypass; Weight regain.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Endoscopic images showing the evolution of the anastomosis along the treatment sessions. From left to right: before treatment; after the first treatment session; before the second treatment session; after the second treatment session; before the last treatment session; and after the last treatment session.
Fig. 2
Fig. 2
Evolution of the caliber of the gastrojejunal anastomosis and gastric retention of solids with argon plasma coagulation treatment.
Fig. 3
Fig. 3
Evolution of the patient's body weight with treatment.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, Schoelles K. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–1737. - PubMed
    1. Parikh M, Pomp A, Gagner M. Laparoscopic conversion of failed gastric bypass to duodenal switch: technical considerations and preliminary outcomes. Surg Obes Relat Dis. 2007;3:611–618. - PubMed
    1. Quadros LG, Kaiser RL Junior, Galvão MD Neto, Campos JM, Santana MF, Ferraz AA. Long-term postoperative endoscopic findings after gastric bypass procedure: a co-occurrence analysis. Arq Gastroenterol. 2016;53:273–277. - PubMed
    1. Baretta GA, Alhinho HC, Matias JE, Marchesini JB, de Lima JH, Empinotti C, Campos JM. Argon plasma coagulation of gastrojejunal anastomosis for weight regain after gastric bypass. Obes Surg. 2015;25:72–79. - PubMed
    1. Vargas EJ, Bazerbachi F, Rizk M, Rustagi T, Acosta A, Wilson EB, Neto MG, Zundel N, Mundi MS, Collazo-Clavell ML, Meera S, Abu-Lebdeh HS, Lorentz PA, Grothe KB, Clark MM, Kellogg TA, McKenzie TJ, Kendrick ML, Topazian MD, Gostout CJ, Abu Dayyeh BK. Transoral outlet reduction with full thickness endoscopic suturing for weight regain after gastric bypass: a large multicenter international experience and meta-analysis. Surg Endosc. 2018;32:252–259. - PMC - PubMed