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Endoscopic Gastric Bypass Revision

To identify the key insights or developments described in this article
1 Credit CME

Weight gain after gastric bypass occurs in a significant portion of patients.1 However, surgical revision of gastric bypass is technically challenging with a high rate of complications.2 Endoscopic revision of the gastric pouch and gastrojejunostomy is an incisionless outpatient procedure with encouraging short- and long-term results.3,4

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Article Information

Corresponding Author: Zachary M. Callahan, MD, Department of Surgery, NorthShore University HealthSystem, 2650 Ridge Ave, GCSI Ste B665, Evanston, IL 60201 (zmcallahan@gmail.com).

Published Online: November 9, 2022. doi:10.1001/jamasurg.2022.5295

Conflict of Interest Disclosures: Dr Ujiki reported personal fees from Boston Scientific, Medtronic, Cook, Olympus, and Gore Medical outside the submitted work; being a consultant for Olympus and Apollo Medical Devices; being a speaker for Apollo Medical Devices, Medtronic, and Gore Medical; and serving on the advisory board for Boston Scientific. No other disclosures were reported.

References
1.
Sjöström  L , Narbro  K , Sjöström  CD ,  et al; Swedish Obese Subjects Study.  Effects of bariatric surgery on mortality in Swedish obese subjects.   N Engl J Med. 2007;357(8):741-752. doi:10.1056/NEJMoa066254PubMedGoogle ScholarCrossref
2.
Dolan  RD , Jirapinyo  P , Thompson  CC .  Endoscopic versus surgical gastrojejunal revision for weight regain in Roux-en-Y gastric bypass patients: 5-year safety and efficacy comparison.   Gastrointest Endosc. 2021;94(5):945-950. doi:10.1016/j.gie.2021.06.009PubMedGoogle ScholarCrossref
3.
Jirapinyo  P , Kumar  N , AlSamman  MA , Thompson  CC .  Five-year outcomes of transoral outlet reduction for the treatment of weight regain after Roux-en-Y gastric bypass.   Gastrointest Endosc. 2020;91(5):1067-1073. doi:10.1016/j.gie.2019.11.044PubMedGoogle ScholarCrossref
4.
Callahan  ZM , Su  B , Kuchta  K , Linn  J , Carbray  J , Ujiki  M .  Five-year results of endoscopic gastrojejunostomy revision (transoral outlet reduction) for weight gain after gastric bypass.   Surg Endosc. 2020;34(5):2164-2171. doi:10.1007/s00464-019-07003-6PubMedGoogle ScholarCrossref
5.
Abu Dayyeh  BK , Lautz  DB , Thompson  CC .  Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass.   Clin Gastroenterol Hepatol. 2011;9(3):228-233. doi:10.1016/j.cgh.2010.11.004PubMedGoogle ScholarCrossref
6.
Schulman  AR , Kumar  N , Thompson  CC .  Transoral outlet reduction: a comparison of purse-string with interrupted stitch technique.   Gastrointest Endosc. 2018;87(5):1222-1228. doi:10.1016/j.gie.2017.10.034PubMedGoogle ScholarCrossref
7.
Vargas  EJ , Abu Dayyeh  BK , Storm  AC ,  et al.  Endoscopic management of dumping syndrome after Roux-en-Y gastric bypass: a large international series and proposed management strategy.   Gastrointest Endosc. 2020;92(1):91-96. doi:10.1016/j.gie.2020.02.029PubMedGoogle ScholarCrossref
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Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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