Obes Surg. 2026 Jul 21. doi: 10.1007/s11695-026-08851-7. Online ahead of print.
ABSTRACT
INTRODUCTION: Endoscopic bariatric procedures (EBTs) are associated with a high incidence of postoperative nausea and vomiting (PONV). We describe our experience with an Enhanced Recovery Protocol (ERP) program for EBTs, comparing healthcare utilization metrics before and after adoption.
METHODS: We instated an ERP for all patients undergoing EBT in our institution, which consisted of intravenous fluids, antiemetics, analgesics and antibiotics peri-procedure, oral antiemetics and analgesics post-procedure, and a structured phone visit 24-48 h post-procedure. We performed a retrospective review of patients undergoing EBT before and after implementation of ERP, with the primary outcome of evaluating healthcare utilization. Healthcare utilization was defined as a visit to the Emergency Room (ER) or Infusion Treatment Centers (ITC), or an inpatient admission. Descriptive and comparative statistics were performed.
RESULTS: Our cohort comprised 434 patients (217 pre- and 217 post-implementation of ERP). Baseline characteristics including age, sex, weight and body mass index were similar between groups. Healthcare utilization was significantly lower in the post-implementation group (15.7% vs. 25.8%, p = 0.01), driven by elimination of ITC visits (0% vs. 4.6%, p < 0.01) and elective post-procedural hospitalizations (0% vs. 7.4%, p < 0.01).
CONCLUSIONS: The adoption of an ERP pathway in EBTs resulted in reduced healthcare utilization post-procedure, driven by lower ITC use and elective post-procedural hospitalizations.
PMID:42479411 | DOI:10.1007/s11695-026-08851-7
