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Background <p>Vertical banded gastroplasty (VBG) was one of the preferred bariatric procedures in the 1980s. It includes a vertical staple line to create a small stomach pouch separated from the remainder of the stomach by a dime size hole. Symptoms of pouch outlet obstruction are a common late complication. At our center, we adopted an EUS-guided gastrogastrostomy with a lumen-apposing metal stent to treat this.</p> Methods <p>We retrospectively analyzed nine consecutive patients who underwent EUS-guided gastrogastrostomy for pouch outlet obstruction (POO) secondary to vertical banded gastroplasty between June 2019 and January 2024.</p> Results <p>The follow-up period varied with a median period of 5.5 months (IQR 5–21). Patients with obstructive symptoms reported resolution of their symptoms and were able to tolerate a general diet. The median weight change was + 3.1 kg (IQR 1–8.45) with a median relative difference of + 3.7% (IQR 0.84–7.25). No adverse events were encountered, except for late stent migration in two patients.</p> Conclusions <p>Gastrogastrostomy with LAMS is effective and safe in treating pouch outlet obstruction in patients with a VBG anatomy. However, late stent migration may occur if not removed. Follow-up is required to monitor for fistula persistence after stent removal and to assess weight gain.</p>

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Endoscopic Ultrasound Guided Gastro-Gastrostomy for Management of Pouch Outlet Obstruction Secondary to Vertical Banded Gastroplasty: Efficacy and Safety

  • 期刊论文

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  • 发表日期：

    2025年7月16日

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  • Gilles Hoilat,
  • Melis Celdir,
  • Henning Gerke

摘要

Background

Vertical banded gastroplasty (VBG) was one of the preferred bariatric procedures in the 1980s. It includes a vertical staple line to create a small stomach pouch separated from the remainder of the stomach by a dime size hole. Symptoms of pouch outlet obstruction are a common late complication. At our center, we adopted an EUS-guided gastrogastrostomy with a lumen-apposing metal stent to treat this.

Methods

We retrospectively analyzed nine consecutive patients who underwent EUS-guided gastrogastrostomy for pouch outlet obstruction (POO) secondary to vertical banded gastroplasty between June 2019 and January 2024.

Results

The follow-up period varied with a median period of 5.5 months (IQR 5–21). Patients with obstructive symptoms reported resolution of their symptoms and were able to tolerate a general diet. The median weight change was + 3.1 kg (IQR 1–8.45) with a median relative difference of + 3.7% (IQR 0.84–7.25). No adverse events were encountered, except for late stent migration in two patients.

Conclusions

Gastrogastrostomy with LAMS is effective and safe in treating pouch outlet obstruction in patients with a VBG anatomy. However, late stent migration may occur if not removed. Follow-up is required to monitor for fistula persistence after stent removal and to assess weight gain.