Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Christine Stier, Mannheim University Hospital, Germany
- Second opponent: Senior Consultant Ivo Boskoski, Fondazione Policlinico Universitario Agostino Gemelli and Università Cattolica del Sacro Cuore, Italy
- Third member and chair of the evaluation committee: Professor Kåre Birkeland, University of Oslo
Chair of the Defence
Professor Pål Gulbrandsen, University of Oslo
Principal Supervisor
Professor II Lars Aabakken, University of Oslo
Summary
Aims
The aim for the thesis was to compare the performance of laparoscopy-assisted endoscopic retrograde cholangiopancreatography (LA-ERCP) and balloon enteroscopy-assisted ERCP (BEA-ERCP) in patients who had been submitted to Roux-en-Y gastric bypass (RYGB). I also sought to investigate the implementation, safety and efficacy of two novel minimally invasive treatment alternatives for obesity: The Elipse intragastric balloon and endoscopic sleeve gastroplasty (ESG).
BEA-ERCP vs LA-ERCP in patients with RYGB anatomy
The study is a retrospective chart review which included 40 BEA-ERCP and 39 LA-ERCP procedures. Adverse events occurred in 18% of BEA-ERCP and 28% of LA-ERCP procedures. Procedure success rate was 72.5% and 87.2% for BEA-ERCP and LA-ERCP, respectively.
Elipse intragastric balloon pilot study
The inclusion criteria were a BMI ≥30 and ≤40 kg/m2 and type 2 diabetes mellitus. 19 patients were included in the study. All balloon insertions were uneventful. One patient developed gastric outlet obstruction and had the balloon endoscopically removed 15 days after insertion. Mean total body weight loss (TBWL) was 3.9% and 0.8% after 16 and 52 weeks, respectively.
Endoscopic sleeve gastroplasty pilot study
10 patients who fulfilled the clinical criteria for obesity surgery were included in the study. All procedures were technically successful except for one with a less than intended gastric volume reduction due to adhesions following a prior umbilical repair. Mean TBWL was 12.2% and 9.1% after 26 and 52 weeks, respectively.
Conclusions
Both LA-ERCP and BEA-ERCP can have high success rates in patients with RYGB anatomy provided advanced expertise. The choice of treatment should be tailored to individual patient needs and available resources. The pilot studies of the Elipse balloon and ESG demonstrated acceptable feasibility. However, neither of the studies confirmed the expected clinical effectiveness.
Additional information
Contact the research support staff.