P1719 - Safety and Feasibility of Same Day Discharge for Endoscopic Bariatric Therapy

Philip Kozan, MD, Jennifer Phan, MD, Adarsh Thaker, MD, Alireza Sedarat, MD, Danny Issa, MD
David Geffen School of Medicine at UCLA, Los Angeles, CA

Introduction: Endoscopic bariatric therapy (EBT) has emerged as a promising option for weight loss as well as a treatment for weight regain following bariatric surgery. The current postprocedural care has been adapted from surgical practices, including overnight admission which may not be necessary for all patients. Here, we describe outcomes for same-day discharge in patients undergoing EBT.

Methods: A prospective observational study was performed to identify obese patients who underwent outpatient EBT for weight loss at a tertiary referral center between July 2018 and June 2021. Clinical data related to postprocedural care, discharge, and procedure-related complications were obtained. Our primary outcome was to determine predictive factors of same-day discharge in patients undergoing outpatient EBT. Statistical analysis was performed using Fisher’s exact test.

Results: Ninety five patients (76 female, mean age 51 ± 10) who underwent EBT were included in this preliminary analysis. Seventy one patients underwent transoral outlet reduction (TORe), 13 had revision of surgical sleeve gastrectomy (re-sleeve), and 11 had primary endoscopic sleeve gastroplasty (ESG), all procedure characteristics listed in table 1. Technical success rate was 100%. Thirteen (77%) patients were discharged on the same procedure day, and 4 (23%) were readmitted for nausea and vomiting. All admitted patients were discharged within 24 hours. Adverse events were reported in 22 (23.2%) patients and were mild according to ASGE lexicon: nausea (n=5), vomiting (n=2), constipation (n=3), and abdominal pain (n=11). There were no moderate or serious adverse events. Univariate analysis identified primary EBT (P=0.024) as a predictors for post-procedural admission. In a subgroup analysis, procedure duration greater than 60 minutes (P=0.014); having index BMI > 40 kg/m2 (P=0.02), and being on oral anticoagulation (p=0.006) were independent predictors for post-procedural admission. There was no significant correlation between admission and age or higher ASA class.

Discussion: This study suggests same-day discharge is safe and feasible for patients undergoing endoscopic weight loss interventions. Primary bariatric therapy, morbid obesity, anticoagulants use and longer procedure duration are indicators for the need for overnight observation. Large prospective studies are ongoing and needed to validate these results.



Disclosures:


Philip Kozan, MD, Jennifer Phan, MD, Adarsh Thaker, MD, Alireza Sedarat, MD, Danny Issa, MD. P1719 - Safety and Feasibility of Same Day Discharge for Endoscopic Bariatric Therapy, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.