Mo1542 Endoscopic Evaluation of Excluded Stomach After Roux-en-Y Gastric Bypass Surgery Using Double Balloon Enteroscopy: a Multicenter Retrospective Analysis.

p 0.261). We did not find any statistical differences regarding age, sex, weight before surgery, surgical morbidity, hospital stay and ASA score between grB and the pts left in the grH not chosen as controls. The rate of IGB failure was 20,9%. The grA had a lower ASA score than the grB (ASA III, 25% vs. 54.2%, p 0.04). The morbidity related to the balloon was 8,3% in grA. Surgical complications rate was 29.2% in grA (38,5% severe) vs 33,3% in grB (58.8% severe). The rate of reoperation was the same (8,3%) in both groups. The hospital stay was 7 days (p25-75: 5.2-8) in grA and 8 d (7-9.2) in grB, p 0.061. One patient died in grB representing a mortality rate of 2,1% in grH. This case-control study did not find statistical differences either in surgical morbidity (p 0.781) or in total morbidity [surgical plus balloon morbidity (p 1)]. There were not differences in morbidity classified as severe (p 1). Multivariable logistic Regression analysis in all the cohort pts (grA+grH),did not find that weight before surgery ,surgical procedure, age of sex were predictor of morbidity Conclusion: 20.9% of pt with IGB failed to lose weight. It seems that preoperative IGB-BIB did not decrease morbidity or hospital stay compared with their matched control group, despite the fact that IGB-BIB group had a lower ASA score than the control group. Multivariate analysis have not proven any relationship between patient weight before surgery and morbidity. Mo1542 Endoscopic Evaluation of Excluded Stomach After Roux-en-Y Gastric Bypass Surgery Using Double Balloon Enteroscopy: a Multicenter Retrospective Analysis. Shiva K. Ratuapli*, Jonathan a. Leighton, Mark E. Stark, James a. Madura, M Edwyn Harrison, Kevin C. Ruff, Louis M. Wong Kee Song, Shabana F. Pasha Gastroenterology, Mayo Clinic Arizona, Scottsdale, AZ; Gastroenterology, Mayo Clinic Florida, Jacksonville, FL; Gastroenterology, Mayo Clinic Rochester, Rochester, MN Background: Roux-en-Y gastric bypass is a commonly performed bariatric surgery in the United States, and has been shown to improve obesity-related medical conditions and quality of life. The excluded stomach after gastric bypass could be a source of gastrointestinal bleeding or malignancy, but is difficult to reach with standard endoscopes. The feasibility of deep enteroscopy instruments, including doubleballoon enteroscopy (DBE), to reach the excluded stomach has been reported in small case series. However, little data exist about the outcome of DBE to reach the excluded stomach in a large group of patients or the factors associated with successful outcome. Aims: The primary aim was to assess the success rate of DBE in reaching the excluded stomach. The secondary aim was to compare the demographic and endoscopic characteristics of patients who underwent successful visualization of excluded stomach with those in whom access to the excluded stomach failed. Methods: All gastric bypass patients who presented to the three Mayo Clinic sites (i.e. Arizona, Florida and Rochester) for DBE between July 2006 and September 2013 were included in the study. All DBE procedures (EN-450T5, Fujinon Photo Optical Co, Japan) were done under general anesthesia. Patients having DBE for ERCP, without intent to reach the bypassed stomach, were excluded. A successful procedure was defined as one in which the excluded stomach was intubated and adequately visualized. Demographic and endoscopic data were compared between groups with and without successful DBE outcome using General Linear Models (JMP v 9.0.1, Cary, NC). Data are presented as means SD. Results: A total of 99 patients (79 women) with mean age of 52 12 years were included in the study. DBE was performed after 107 80 months of the initial gastric bypass surgery. Gastrointestinal bleeding and iron deficiency anemia were the most common indications (nZ46; 46%) for performing DBE, followed by abdominal pain (nZ29; 29%) and abnormal imaging studies (nZ13; 13%). The excluded stomach was visualized in 73 (74%) patients. Among those in whom the excluded stomach was reached, gastric abnormalities were present in 22(30%) cases [gastric erythema 10 (14%), erosions 7 (9%), ulcers 2 (3%), polyps 2 (3%) and arteriovenous malformation 1 (1%)]. There were no adverse events. Patients in whom the excluded stomach was reached were significantly younger and had shorter Roux limb compared to those where DBE failed to reach the excluded stomach (Table). Conclusion: In this large multicenter study, DBE was safe and successful in evaluating the excluded stomach in 74% of the gastric bypass patients. Younger age and shorter Roux limbs were associated with successful outcome. Our data suggest that DBE is an effective tool to evaluate the excluded stomach in the setting of difficult post-surgical anatomy. Comparison of demographic and endoscopic characteristics between the groups www.giejournal.org DBE successful in reaching excluded stomach DBE unsuccessful in reaching excluded stomach pvalue Age (yrs, nZ 99) 50 12 57 11 0.01 BMI (nZ99) 30 7 34 10 0.05 Female gender (%, nZ99) 60 (82%) 19 (73%) 0.32 Vol ume 79, No. 5S : 201 DBE successful in reaching excluded stomach 4 GASTROINTEST DBE unsuccessful in reaching excluded stomach INAL ENDOSCOPY pvalue Duration of procedure (min, nZ 50) 87 27 94 38 0.52 Length of biliopancreatic limb (cm, nZ 41) 52 15 48 23 0.52