DDW 2019—Less invasive gastroplasty safe and effective


  • Sean Henahan
  • Conference Reports
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Takeaway

  • Endoscopic sleeve gastroplasty provides more weight loss in obese patients with nonalcoholic fatty liver disease (NAFLD).

Why this matters

  • NAFLD accounts for more than two-thirds of patients with chronic liver disease in the United States.
  • Many patients cannot lose enough weight with conventional lifestyle modifications and pharmacotherapy.
  • Some can benefit from bariatric surgery.
  • A less invasive approach to bariatric surgery could allow wider treatment.
  • Endoscopic sleeve gastroplasty, also known as the accordion procedure, uses an endoscopic suturing device to reduce the size of the stomach.
  • The minimally invasive procedure has a reduced risk of complications.

Study design

  • 5-year longitudinal study.
  • 203 consecutive patients underwent endoscopic sleeve gastroplasty, performed by 1 surgeon.
  • Two-thirds were female.
  • 176 met the study criteria.
  • All patients had NAFLD.
  • Patients were followed for at least 1 year.

Key results

  • Average BMI before surgery was 39 kg/m2, decreasing to 34 kg/m2 at the end of follow-up (P<.0001>
  • Average weight loss was 13% (P<.0001>
  • During follow-up, average alanine aminotransferase levels decreased significantly, as did average aspartate aminotransferase levels.
  • Patients showed significant improvement in NAFLD as determined by Hepatic Steatosis Index and FIB(fibrosis)-4 score pre- and postoperative evaluations.

Limitations

  • The study was not a randomized, placebo-controlled trial.

 

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