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The utility of EndoFLIP for measuring gastrojejunal anastomosis diameter and distensibility in patients experiencing weight regain post Roux-en-Y gastric bypass

: Haq, Zadid; Itani, Mohamad I.; Zhang, Linda; Dinary, Fazel; Farha, Jad; Abbarh, Shahem; Akshintala, Venkata; Koller, Kristen; Jovani, Manol; Hedjoudje, Abdellah; Ngamruengphong, Saowanee; Oberbach, Andreas; Badurdeen, Dilhana; Kumbhari, Vivek


Obesity surgery (2021), Online First, 7 S.
ISSN: 0960-8923 (Print)
ISSN: 1708-0428 (Online)
Fraunhofer IZI ()
EndoFLIP; GJA diameter; GJA distensibility; Roux-en-Y gastric bypass; weight regain

A dilated gastrojejunal anastomosis (GJA) diameter is an independent predictor of weight regain following Roux-en-Y gastric bypass (RYGB). Despite this, there is no standardized method for GJA diameter measurement. We performed a retrospective analysis to compare endoscopic visual estimation and endoluminal functional impedance planimetry (EndoFLIP) for measuring GJA diameter in patients with weight regain post-RYGB. Visual estimation was found to overestimate GJA diameter by a mean of 4.2mm ± 4.6mm when compared with EndoFLIP. Furthermore, we identified symptomatic patients with normal GJA diameter but increased distensibility, which may represent a previously unrecognized subgroup. Our findings suggest the potential utility of EndoFLIP in the evaluation of post-RYGB weight regain and support the need for prospective studies to investigate the relationship between GJA distensibility and weight regain.