Ameya Deshmukh, DO1, Parth Desai, DO2, Christine Ma, MD3, Vladimir Kushnir, MD4, Shaina Eckhouse, MD4, Francesca Dimou, MD4, Thomas R.. McCarty, MD5, Ahmad Najdat Bazarbashi, MD6 1Saint Louis University Hospital, St. Louis, MO; 2Reading Hospital, Reading, PA; 3Washington University in St. Louis School of Medicine, St. Louis, MO; 4Washington University in St. Louis, St. Louis, MO; 5Houston Methodist Hospital, Houston, TX; 6Washington University in St. Louis/Barnes Jewish Hospital, St. Louis, MO
Introduction: Gastric band erosion may be seen in up to 3% of cases with patients remaining asymptomatic or presenting with abdominal pain or signs of gastrointestinal obstruction. Endoscopic intervention has become increasingly utilized due to its minimally invasive nature. The primary aim of this study was to perform a systematic review and meta-analysis to examine the role of endoscopic removal of eroded gastric bands.
Methods: Individualized search strategies were developed for PubMed, EMBASE, Web of Science, and Cochrane Library databases from inception through November 2022 in accordance with PRISMA and MOOSE guidelines. Measured outcomes included technical success, clinical success, procedure duration, adverse events, and conversion to surgery. This was a cumulative meta-analysis performed by calculating pooled proportions with rates estimated using random effects models. Heterogeneity was assessed with I2 statistics and publication bias by funnel plot asymmetry. Meta-regression analyses were performed comparing outcomes by endoscopic removal tool.
Results: A total of 10 studies (n=282 patients) were included in this meta-analysis. One prospective and 9 retrospective studies were included. Mean age of patients was 40.68 ±7.25 years. A majority of patients (79%) were female gender. Mean pre-operative body mass index (BMI) for included patients was 42.76 ±1.06 kg/m2 while average BMI at time of band erosion was 33.06 ±3.81 kg/m2. The average duration of gastric band placement was 38.49 ±19.88 months. Endoscopic removal was attempted in 240/282 (85.11%) of cases. Pooled technical and clinical success of the endoscopic therapy was 86.08% (CI: 79.42-90.83) and 85.34% (CI: 88.70-90.62), respectively. Mean procedure time for endoscopic removal was 46.47 ±11.52 minutes with an intra-operative adverse event rate of 4.15% (CI: 1.98-8.51). Post-procedure associated adverse events occurred in 7.24% (CI: 4.46-11.55) of patients. Conversion to laparotomy/laparoscopy occurred in 10.54% (CI: 6.12-17.54%) of cases. Additionally, meta-regression did not demonstrate any significant differences between specific gastric band tools utilized during endoscopic removal in technical (p=0.831), clinical success (p=0.66), intra- or post-procedure adverse events (p=0.62 and p=0.35), and conversion to surgery (p=0.84).
Discussion: Endoscopic intervention appears to be a highly effective and safe modality for the treatment of gastric band erosion.
Disclosures:
Ameya Deshmukh indicated no relevant financial relationships.
Parth Desai indicated no relevant financial relationships.
Christine Ma indicated no relevant financial relationships.
Vladimir Kushnir indicated no relevant financial relationships.
Shaina Eckhouse indicated no relevant financial relationships.
Francesca Dimou indicated no relevant financial relationships.
Thomas McCarty indicated no relevant financial relationships.
Ahmad Najdat Bazarbashi indicated no relevant financial relationships.
Ameya Deshmukh, DO1, Parth Desai, DO2, Christine Ma, MD3, Vladimir Kushnir, MD4, Shaina Eckhouse, MD4, Francesca Dimou, MD4, Thomas R.. McCarty, MD5, Ahmad Najdat Bazarbashi, MD6. P3702 - Endoscopic Management of Gastric Band Erosion: A Systematic Review and Meta-Analysis, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.
