One-year Clinical Outcomes of Endoscopic Cardia Banding Plication for Refractory Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy

August 2, 2026 updated by: Hua Meng, China-Japan Friendship Hospital

One-year Clinical Outcomes of Endoscopic Cardia Banding Plication for Refractory Gastroesophageal Reflux Disease After Laparoscopic Sleeve Gastrectomy: a Single-center Retrospective Cohort Study

This single-center retrospective cohort study was conducted at the Center for Bariatric and Metabolic Surgery, China-Japan Friendship Hospital, Beijing, China, and is reported in accordance with the STROBE guidelines for observational studies [18]. Consecutive eligible patients were enrolled between 28 September 2022 and 29 July 2025; each patient was followed under a standardized 12-month schedule, with the last follow-up visit on 16 July 2026 and data extraction on 17 July 2026. The study protocol was approved by the institutional ethics committee , and the requirement for individual informed consent was waived because of the retrospective design and use of de-identified data. To minimize selection and information bias, consecutive eligible patients were enrolled, all procedures were performed by a single operator, symptoms were assessed with a standardized questionnaire on a fixed follow-up schedule, and data were extracted in de-identified form. All consecutive eligible patients during the study period were included; no a priori sample-size calculation was performed given the exploratory design. There were no missing data for analyzed variables; patients with incomplete baseline or follow-up data were excluded.

Consecutive patients who underwent ECBP for refractory GERD after LSG were screened. Eligible patients met the following inclusion criteria: (i) previous LSG for obesity; (ii) refractory GERD, defined as persistent typical reflux symptoms despite standard-dose PPI therapy for at least 8 consecutive weeks; (iii) age ≥18 years; and (iv) completion of a standardized 12-month postoperative follow-up. Exclusion criteria included: (i) hiatal hernia identified on preoperative endoscopy, because band ligation of the cardia is not expected to correct the anatomical defect associated with a hiatal hernia, and such patients are generally referred for alternative management; (ii) previous gastric or anti-reflux surgery other than LSG; (iii) contraindications to endoscopic intervention; and (iv) incomplete baseline or follow-up data. All patients underwent routine preoperative endoscopic evaluation to confirm the absence of hiatal hernia and to characterize the gastroesophageal junction. A total of 47 patients were included (ECBP alone, n = 38; ECBP plus BTX, n = 9); patients who did not complete the 12-month follow-up were excluded, and all 47 included patients completed the standardized 12-month schedule.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This single-center retrospective cohort study was conducted at the Center for Bariatric and Metabolic Surgery, China-Japan Friendship Hospital, Beijing, China, and is reported in accordance with the STROBE guidelines for observational studies [18]. Consecutive eligible patients were enrolled between 28 September 2022 and 29 July 2025; each patient was followed under a standardized 12-month schedule, with the last follow-up visit on 16 July 2026 and data extraction on 17 July 2026. The study protocol was approved by the institutional ethics committee , and the requirement for individual informed consent was waived because of the retrospective design and use of de-identified data. To minimize selection and information bias, consecutive eligible patients were enrolled, all procedures were performed by a single operator, symptoms were assessed with a standardized questionnaire on a fixed follow-up schedule, and data were extracted in de-identified form. All consecutive eligible patients during the study period were included; no a priori sample-size calculation was performed given the exploratory design. There were no missing data for analyzed variables; patients with incomplete baseline or follow-up data were excluded.

Consecutive patients who underwent ECBP for refractory GERD after LSG were screened. Eligible patients met the following inclusion criteria: (i) previous LSG for obesity; (ii) refractory GERD, defined as persistent typical reflux symptoms despite standard-dose PPI therapy for at least 8 consecutive weeks; (iii) age ≥18 years; and (iv) completion of a standardized 12-month postoperative follow-up. Exclusion criteria included: (i) hiatal hernia identified on preoperative endoscopy, because band ligation of the cardia is not expected to correct the anatomical defect associated with a hiatal hernia, and such patients are generally referred for alternative management; (ii) previous gastric or anti-reflux surgery other than LSG; (iii) contraindications to endoscopic intervention; and (iv) incomplete baseline or follow-up data. All patients underwent routine preoperative endoscopic evaluation to confirm the absence of hiatal hernia and to characterize the gastroesophageal junction. A total of 47 patients were included (ECBP alone, n = 38; ECBP plus BTX, n = 9); patients who did not complete the 12-month follow-up were excluded, and all 47 included patients completed the standardized 12-month schedule.

Study Type

Interventional

Enrollment (Actual)

47

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • China
    • Beijing Municipality
      • Beijing, Beijing Municipality, China, 100029
        • China Japan Friendship Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • previous LSG for obesity;
  • refractory GERD, defined as persistent typical reflux symptoms despite standard-dose PPI therapy for at least 8 consecutive weeks;
  • age ≥18 years; a
  • completion of a standardized 12-month postoperative follow-up

Exclusion Criteria:

  • hiatal hernia identified on preoperative endoscopy, because band ligation of the cardia is not expected to correct the anatomical defect associated with a hiatal hernia, and such patients are generally referred for alternative management;
  • previous gastric or anti-reflux surgery other than LSG;
  • contraindications to endoscopic intervention; - incomplete baseline or follow-up data. All patients underwent routine preoperative endoscopic evaluation to confirm the absence of hiatal hernia and to characterize the gastroesophageal junction

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: endoscopic cardia banding plication
Procedure: endoscopic cardia banding plication
Endoscopic cardia banding plication (ECBP) narrows the cardiac orifice by band ligation alone, without mucosal resection, and may potentially combine technical simplicity with a favorable safety profile; however, evidence in the post-LSG setting remains scarce. Botulinum toxin (BTX), established for modulating sphincteric tone in achalasia and investigated intragastrically for weight control with conflicting meta-analytic results

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gastroesophageal Reflux Disease Questionnaire
Time Frame: 1 year
There are six items: heartburn, abdominal pain, reflux, nausea, sleep disturbances, and frequency of additional medication. Each item is scored based on its frequency of occurrence, with 0, 1, 2-3, and ≥4 days in the past week corresponding to scores of 0, 1, 2, and 3, respectively. The total score ranges from 0 to 18, with a higher score indicating more severe symptoms
1 year

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

China-Japan Friendship Hospital

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 28, 2022

Primary Completion (Actual)

September 29, 2025

Study Completion (Actual)

September 29, 2025

Study Registration Dates

First Submitted

July 23, 2026

First Submitted That Met QC Criteria

August 2, 2026

First Posted (Actual)

August 6, 2026

Study Record Updates

Last Update Posted (Actual)

August 6, 2026

Last Update Submitted That Met QC Criteria

August 2, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2021-112-K70-1
  • Elite Medical Professionals Pr (Other Identifier: China Japan Friendship Hospital)

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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