C0452 - Endoscopic Sleeve Gastroplasty Performed by Gastroenterologists vs Bariatric Surgeons: Are There Differences in Short-Term Outcomes?

Anuragh Gudur, MD, Calvin Geng, MD, Mark Radlinski, MD, Vanessa Shami, MD, Andrew Wang, MD, Alexander Podboy, MD
University of Virginia, Charlottesville, VA

Introduction: Endoscopic sleeve gastroplasty (ESG) is an emerging bariatric intervention designed to imitate surgical sleeve gastrectomy (SG), with demonstrated safety and efficacy in early clinical studies. Both gastroenterologists and bariatric surgeons currently perform ESG, but there is a lack of data evaluating the impact of proceduralist specialization on short-term outcomes following ESG. Prior studies analyzing SG have suggested that variations in training background and specialty impact clinical outcomes of the procedure. This study aims to assess whether proceduralist specialization impacts short-term (30d) safety after ESG

Methods: All patients who underwent ESG from 2016-2020 across 800 different hospitals in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) database were stratified into two cohorts depending on the specialty of the physician performing the procedure. These cohorts were then propensity matched using baseline patient characteristics. We primarily compared adverse events (AE), readmissions, re-operations, and re-interventions within 30 days after procedure. Secondary outcomes included procedure time, length of stay (LOS), total body weight loss (TBWL), and emergency room (ER) visits within 30d.

Results: Following propensity matching, there were no differences in baseline characteristics between patients who underwent ESG with a gastroenterologist or bariatric surgeon. There was no difference in AE in ESG performed by either specialty (p >0.05). ESG performed by bariatric surgeons led to a higher rate of reoperations within 30 days (p=0.025). ESG performed by gastroenterologists led to more ER visits but did not lead to a higher rate of readmissions or reinterventions. LOS was shorter in ESG performed by gastroenterologists, whereas procedure time was longer.

Discussion: ESG is safely performed by both gastroenterologists and bariatric surgeons. Patients who underwent ESG with a gastroenterologist visited the ER more often, while bariatric surgeons were more likely to re-operate on patients within 30d—perhaps highlighting variations in technique or postprocedural management. Both specialties should continue collaborating to expand access while standardizing procedural technique and competency requirements.


Disclosures:


Anuragh Gudur, MD, Calvin Geng, MD, Mark Radlinski, MD, Vanessa Shami, MD, Andrew Wang, MD, Alexander Podboy, MD. C0452 - Endoscopic Sleeve Gastroplasty Performed by Gastroenterologists vs Bariatric Surgeons: Are There Differences in Short-Term Outcomes?, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.