Background

Endoscopic gastric pouch plications/revisions (EGP-PR) have gained popularity as novel approach to manage weight-related difficulties or postoperative complications after bariatric surgery. Unfortunately, data on safety of these revisions is still limited. This study evaluated the 30-day rate of serious complications and mortality of EGP-PR.

Methods

A retrospective analysis of the MBSAQIP database from 2020 to 2022 was conducted. Patients undergoing EGP-PR were analyzed. The primary outcomes were 30-day serious complications and mortality.

Results

A total of 1474 patients were included in this analysis. Baseline characteristics are described in Table 1. The most common indications for EGP-PR in this cohort included weight gain (71.9%), inadequate weight loss (15.1%), dumping syndrome (5.5%), GERD (4.1%), gastrointestinal tract fistula (1.0%) and others (0.9%). The mean operative time was 41.2 +- 35.2 minutes and the mean hospital stay was 0.35 +- 0.7 days. Postoperative complications comprised readmissions within 30 days (3.1%), serious complications (3.3%), interventions within 30 days (2.5%), bleeding (0.8%), reoperations (0.4%) and a mortality rate of 0%. On multivariable analysis, GERD was independently predictive of serious complications (OR 1.7, 95%CI 0.98 to 3.2, p=0.05) when adjusting for age, sex, BMI, comorbidities, and operative time. No multivariable mortality analysis was conducted as there were no deaths.

Conclusions

EGP-PR is uncommon with only 1474 procedures reported and weight regain is representing 71.9% of the indications. EGP-PR offers an alternative approach to surgical revision, which appears to be relatively safe. However, data assessment of efficacy and comparison to corresponding surgical revisions is needed.