ENDOSCOPIC SURVEILLANCE FOLLOWING MINI GASTRIC BYPASS: THE ROLE OF COMPUTED VIRTUAL CHROMOENDOSCOPY TECHNOLOGIES (EGDS-CVCT)

Introduction: Despite several authors have reported excellent resultswith the Mini Gastric Bypass technique (MGB), potential histologic damage determined by bile reflux into stomach or esophagus is considered by some bariatric surgeons a reason to avoid this technique. Endoscopic (EGDS) Computed Virtual Chromoendoscopy Technologies (CVCT) are imaging techniques designed to enhance visualization of the vascular network and surface texture of the gastrointestinal mucosa, to improve tissue characterization differentiation, and finally to address biopsy of suspicious areas as well. Objectives: To evaluate findings provided by EGDS-CVCT in the follow up of patients (pts) who underwent laparoscopic Mini Gastric Bypass (MGB). Methods: Starting from 2009, 120 MGBs have been performed in two units. All pts were evaluated by EGDS-CVCT before surgery. Beginning from 2010 a routine EGDS-CVCT surveillance has been planned for all pts at 12, 36 and 60 months after surgery. Twenty-five asymptomatic pts (18 F–7 M) with a preoperative BMI of 51.7±7.1 have reached 36 months of follow up. Results: All 25 surgeries were performed with no complications in an operative time of 115±15.6 min. BMI at 36months was 30.3±4.4. EGDS-CVCT diagnosed no esophagitis in 23 pts (92%) and grade I Los Angeles esophagitis in 2 pts (8%). A mild chronic gastritis was detected in 21 pts (84 %), while 4 pts (16 %) presented with moderate chronic gastritis. All data were confirmed by histology. No dysplasia or intestinal metaplasia were found. Conclusion: Although a longer follow up would be of interest, EGDS-CVCT at 36 months fromMGB surgery has not shown any worrisome finding in our series.