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Endoscopic blind limb reduction with septotomy for the treatment of candy cane syndrome after Roux-en-Y gastric bypass: Pilot feasibility study
Journal article   Open access   Peer reviewed

Endoscopic blind limb reduction with septotomy for the treatment of candy cane syndrome after Roux-en-Y gastric bypass: Pilot feasibility study

Kambiz Kadkhodayan, Zubair Khan, Shayan Irani, Artur Viana, Saurabh Chandan, Sagar Pathak, Abdullah Abbasi, Mustafa A Arain, Maham Hayat, Deepanshu Jain, …
Endoscopy International Open, Vol.13, p.a25097573
2025
DOI: 10.1055/a-2509-7573
PMCID: PMC11855250
PMID: 40007657
url
https://doi.org/10.1055/a-2509-7573View
Published (Version of record) Open Access

Abstract

Background and study aims Candy cane syndrome (CCS) refers to patients with a long and symptomatic blind afferent roux limb (BARL) after Roux-en-Y gastric bypass (RYGB). Revisional surgery is efficacious but can be cost prohibitive. Patients and methods We describe endoscopic blind limb reduction (EBLR), that converts the BARL into a "common channel" and eliminates food pooling, thereby improving symptoms. Patients that did not have a complete symptomatic response underwent a repeat EBLR or EBLR with septotomy (EBLR-S) based on residual BARL length. Results Five patients with CCS underwent the EBLR procedure. Mean age was 60.4 years, average BARL length 5.8 cm, and median Charlson comorbidity index was 3. Technical success was achieved in all five patients (100%). Symptom resolution was achieved in all five patients (100%). Two patients required a second procedure. Conclusions EBLR may be a potentially safe, efficacious, and cost-effective alternative to surgery in patients with CCS. Further prospective studies are needed.
 Surgery Gastroenterology & Hepatology Life Sciences & Biomedicine Science & Technology

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