ratio from 5.75 to 4.36 (p = 0.0001) with 42.6% of the patients presenting a TG/ HDL ratio lower than 3.5 at the end of the study. However, the improvement of the TG/HDL is strongly associated with loss of more than 10% of the initial weight. Conclusion: The DJBL, when used for a period of 6 months, is effective in the control of T2DM, weight loss, improvement of insulin resistance, improvement of the metabolic syndrome, and decrease of cardiovascular risk among morbidly obese patients with type 2 diabete melitus Sa1429 Influence of the Duodenojejunal Bypass Liner in the Gastric Emptying Eduardo G. De Moura* 1 , Guilherme Sauniti 1 , Bruno C. Martins 1 , Ivan R. Orso 1 , Suzana L. De Oliveira 1 , Marco AuréLio Santo 2 , Marcio C. Mancini 4 , Manoel P. Galvao Neto 3 , Almino C. Ramos 3 , Arthur B. Garrido 2 , Alfredo Halpern 4 , Paulo Sakai 1 , Ivan Cecconello 2 1 Gastroenterology Department - University of Sao Paulo, Endoscopy Unit - Hospital das Clinicas, Sao Paulo, Brazil; 2 Gastroenterology, Gastrointestinal Surgery - University of Sao Paulo - School of Medicine, Sao Paulo, Brazil; 3 Gastroenterology, Gastro Obeso Center, Sao Paulo, Brazil; 4 Endocrinology, University of Sao Paulo - School of Medicine, Sao Paulo, Brazil Introduction: A new treatment for obesity and type 2 diabetes, the duodenal jejunal bypass liner, a totally endoscopic device, been gaining ground in recent years. Despite the good results, the mechanisms of action of DJBL have not been studied. Objective: To study the changes promoted by DJBL gastric emptying, and the relationship of these changes with clinical outcomes while using the device. Methods: 25 obese and type 2 diabetes, who used the DJBL for a minimum of 16 weeks and maximum of 24 weeks, perform scintigraphic gastric emptying test, with standard meal labeled, and with analysis of 1, 2 and 4 hours after ingestion, before, during 16 weeks of use, and after 4 weeks of withdrawal of DJBL. We obtained measurements of weight, glycated hemoglobin, triglycerides and HDL, before placing the device and after 4 weeks of their withdrawal. The mean and standard deviation of gastric retention were obtained and compared between the three tests, and after, compared between patients who were and those that failed in selected clinical parameters (weight loss greater than 10%, glycated hemoglobin less than 7%, and TGL/HDL ratio less than 3.5). We also assessed subjectively satiety and food intake during the 16 weeks of using the device. Results: At baseline examination, 23 patients had normal gastric emptying and, 2 accelerated gastric emptying. In the examination of 16 weeks of use, 12 patients had slowing of the exam, and after 4 weeks of withdrawal, we observed 3 with delayed gastric emptying and 1 accelerated. When evaluated average retention, during the 16th week of use, there is greater retention for the first, second and fourth hour compared to baseline (1st h 74  16.3% p = 0.001, 2nd h 45  25% p 0.001; 4th  15 15.8% p 0.001). For the fourth hour of examination, there is no statistical difference between the baseline examination and the fourth week post-withdrawal (2  2% and 4%  5.9% p = 0.57). When compared, there is no statistical difference between the gastric retention in the 16th week among patients who achieved and those who did not achieve control of diabetes (p = 0.73), among those who lost more than 10% in weight and those who did not lose (p = 0.275) and among those who decreased the ratio TGL/HDL ratio to less than 3.5 and not decreased (p = 0.89). During the 16th week of use, 23 patients (92%) reported increased sense of early satiety and satiation greater, and all reported eating less food volume for the period prior to placement of the device. Conclusion: The DJBL cause delayed gastric emptying, reversible after discontinuation, but this change in gastric emptying, despite being symptomatic with increased satiety and satiation, reducing the volume of food ingested, has no relation to weight loss, improvement of diabetes or TGL/HDL ratio. Sa1430 Transoral Outlet Reduction for Treatment of Weight Regain After RYGB: a Number Needed to Treat Analysis Nitin Kumar*, Marvin Ryou, Christopher C. Thompson Division of Gastroenterology, Brigham & Women’s Hospital, Boston, MA Background: Weight regain after Roux-en-Y gastric bypass (RYGB) is correlated with dilated gastrojejunal anastomosis (GJA). Transoral outlet reduction (TORe) entails endoscopic suturing to reduce GJA aperture. Aim: To determine number needed (NNT) to treat for TORe in patients with weight regain after RYGB. Methods: Consecutive patients undergoing TORe at an academic medical center using one type of endoscopic suction-based superficial suturing device for treatment of weight regain with GJA dilation 12mm were retrospectively identified. The rate of weight change prior to TORe was determined and used as a baseline for each patient. Post-TORe weight change over a 6-, 12-, and 24- month follow-up period was determined for each patient. Difference in weight change rate prior to TORe and weight change rate after TORe over each follow- up interval was used to determine the treatment effect size for each patient. Outcome was NNT based on risk of not achieving excess weight loss (EWL) target versus preTORe baseline during the follow-up period. All statistics are reported as mean  SEM. Results: 128 patients (47.0 0.8 yr, 6M/122F, BMI 54.2 0.9 kg/m 2 ) underwent RYGB with %EWL of 75.8 1.9% at nadir (loss of 126.1 4.1 lb). Before TORe, patients regained 34.1 2.3% of lost weight to result in BMI of 40.0 0.7. Pre-TORe GJA size was 23.6 0.6 mm. 3.3 1.9 plications were placed at the GJA, resulting in GJA reduction to 7.0 0.2 mm. Follow-up duration was 684 58 days.NNT to achieve 5% EWL at 6-24 months was 2. NNT to achieve 10% EWL at 12-24 months was 2. NNT to achieve 20% EWL at 6-24 months was 3. The results achieved within six months were durable through 24 months. A graph for NNT by follow-up interval is shown in Figure 1. Conclusions: In RYGB patients with weight regain, TORe is an effective therapy with durable results. NNT rises steadily with target %EWL, but is stable even over extended follow-up periods. Sa1431 Endoscopic Removal of Partially Migrated Intra-Gastric Bands Following Surgical Gastroplasty: a Prospective Case Series Demonstrating Safety and Efficacy Iyad N. Khamaysi*, Ian M. Gralnek, Alain Suissa, Kamel a. Yassin Gastroenterology, Technion-Israel Institute of Technology & Rambam Medical Center, Haifa, Israel Background and Aims: Laparoscopic gastric banding is a popular surgical technique for morbid obesity. However, the intra-gastric partial migration of bands is a well-recognized complication, leading to loss of weight reduction efficacy and bothersome upper gastrointestinal symptoms. Intra-gastric band partial migration usually necessitates repeat surgery for correction. To avoid surgery, minimally invasive techniques such as endoscopic band removal, is reported to be effective, yet reports are sporadic and scarce [1]. We report on the efficacy and safety of endoscopic removal of partially migrated intra-gastric bands in a prospective case series. Methods: From 1/1/11 to 15/11/12, we prospectively collected data on patients referred to a tertiary-care university hospital for endoscopic removal of migrated intra-gastric bands previously diagnosed at gastroscopy. All patients had abdominal pain, nausea, vomiting, and recurrent weight gain at the time of presentation. Under endoscopic visualization, using a standard gastroscope, the partially migrated band was visually identified within the gastric lumen, a 0.035 inch Jagwire was introduced, looped through the band and withdrawn to the mouth using a grasper. A mechanical lithotriptor was then threaded over the Jagwire and under fluoroscopic guidance slowly advanced. By twisting the handle of the lithotripter, the band was readily cut by strangulation using a “butter-cutter wire” technique. Figure 1. The cut edge of the band was then grasped using a colon snare and with gentle traction extracted from the gastric wall and then removed per os. Figure 2. Results: There were n=7 patients (4F/3M, mean age 38.4 years) referred for partially migrated intra-gastric band endoscopic removal. Mean time from laparoscopic gastric band placement to endoscopic intra-gastric band removal was 6.2 years. The migrated intra-gastric bands were all successfully removed in a mean of 1.3 sessions. No patient required subsequent surgical intervention for their partially migrated intra-gastric band. There were no Figure 1. NNT by follow-up duration and %EWL Abstracts AB202 GASTROINTESTINAL ENDOSCOPY Volume 77, No. 5S : 2013 www.giejournal.org