Indications and Outcomes of Endoscopic Gastric Pouch Plications After Bariatric Surgery: An Analysis of the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) Database

Background: Endoscopic gastric pouch plications (EGPP) have emerged as a novel approach for managing weight-related issues and postoperative complications following bariatric surgery. However, safety data for these revisions remains limited. Objective: This study aims to evaluate the 30-day rate of serious complications and mortality associated with EGPP using the MBSAQIP database. Setting: Hospital Methods: A retrospective analysis of the MBSAQIP database from 2020 to 2022 was conducted, focusing on patients undergoing EGPP. The primary outcomes were 30-day serious complications and mortality. Results: The study included 1,474 patients. Weight recurrence (71.9%) was the most common indication for EGPP, followed by inadequate weight loss (15.1%), dumping syndrome (5.5%), reflux (4.1%), gastrointestinal tract fistula (1.0%), and others (0.9%). The mean operative time was 41.2 ± 35.2 minutes, with a mean hospital stay of 0.4 ± 0.7 days. Postoperative complications included 30-day readmissions (3.1%), serious complications (3.3%), 30-day interventions (2.5%), bleeding (0.8%), and reoperations (0.4%). The mortality rate was 0%. Multivariable analysis showed GERD as an independent predictor of serious complications (OR 1.7, 95% CI 0.98 to 3.2, p =0.05) when adjusting for various factors. Conclusion: EGPP is an uncommon procedure with only 1,474 cases reported, primarily indicated for weight recurrence. It appears to be a relatively safe alternative to surgical revision. However, further research is needed to assess its efficacy and compare it to corresponding surgical revisions.