ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (Live and Virtual) | May 2023-Case Discussion #2 and Panel Q&A

Video Transcription

Video Summary

In this video, the speakers discuss the use of pharmacotherapy and bariatric endoscopy for weight loss and weight regain in patients with obesity. They talk about the timing of adding pharmacotherapy to patients who have undergone intragastric balloon placement, suggesting that it may be reasonable to start pharmacotherapy at the time of balloon removal or when weight regain occurs. They also discuss the use of pigtails as a treatment for leaks in patients who have undergone bariatric surgery, with one doctor mentioning that they have adjusted their practice to use pigtails earlier for leaks. The speakers also discuss the referral pathway for patients with obesity, explaining that patients may be referred to either obesity medicine experts or bariatric endoscopy experts depending on their specific needs and preferences. They also mention the importance of patient preferences when considering treatment options such as bariatric endoscopy. The speakers also discuss the use of medications for weight loss and when to consider bariatric endoscopic procedures. They mention that if patients reach a plateau with medications, they may add additional medications rather than switching to a different medication. They also mention that the decision to consider bariatric endoscopy depends on the patient's preferences and specific circumstances. One doctor shares a case in which a patient initially opposed bariatric endoscopy but eventually decided to pursue it due to weight regain. The speakers also discuss the nuances of performing ERCP with stent placement, mentioning that the decision to proceed with the procedure on the same day depends on factors such as access points, stent size, and scope position. They also mention the use of through-the-scope esophageal stents as a backup plan in case of stent migration. No credits were mentioned in the video.

Keywords

pharmacotherapy

bariatric endoscopy

obesity

weight loss

patient preferences