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Long-term results of sclerotherapy for dilated gastrojejunostomy after gastric bypass
Laurie Spaulding1, Turner Osler, Johann Patlak
1Department of General Surgery, Fletcher Allen Health Care and University of Vermont College of Medicine, Burlington, Vermont, USA.
Background:
Endoscopic sclerotherapy with sodium morrhuate of a dilated gastrojejunostomy in gastric bypass patients has been shown to narrow the diameter of the anastomosis and provide weight loss or weight stability 3-6 months after the procedure. Longer term results for this procedure are needed.
Methods:
From 1999 to 2006, sclerotherapy was performed on 147 gastric bypass patients with a dilated gastrojejunostomy. In a retrospective review, 32 patients were identified for whom > or =12 months of postprocedure data were available. Their weight trends before and after treatment were assessed by paired t test.
Results:
A total of 32 patients who were gaining weight after gastric bypass underwent sclerotherapy of their dilated gastrojejunostomy. The timing of treatment ranged from 10 to 140 months (average 56) after Roux-en-Y gastric bypass. Before sclerotherapy, patients were gaining weight at a rate of .36 kg/mo. After treatment, they were losing weight at a rate of .39 kg/mo. After treatment, 56.3% of patients began to lose weight, 34.4% had their weight stabilize, and 9.4% continued to gain weight.
Conclusion:
The results of our study have shown that sclerotherapy for a dilated gastrojejunostomy after gastric bypass is a minimally invasive procedure that provides a 91.6% chance of postprocedure weight loss or stabilization for 1 year after treatment.
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