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Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass.

Abstract：

BACKGROUND:Roux-en-Y gastric bypass is the most frequently performed bariatric surgery for morbid obesity. Gastrojejunal anastomotic strictures are a relatively frequent postoperative complication. OBJECTIVE:To evaluate the clinical outcomes and therapeutic response to through-the-scope balloon dilation performed to treat anastomotic strictures after Roux-en-Y gastric bypass surgery. DESIGN:Single-center, retrospective study. SETTING:Academic medical center. PATIENTS:Between 1997 and 2005, 801 patients with morbid obesity underwent Roux-en-Y gastric bypass surgery at our institution. MAIN OUTCOME MEASUREMENTS:The development of an anastomotic stricture after Roux-en-Y gastric bypass surgery. The response to through-the-scope balloon dilation after diagnosis. RESULTS:Forty-three of 801 patients (5.4%) developed an anastomotic stricture (26 of 294 open surgeries [8.8%]; 17 of 507 laparoscopic surgeries [3.4%]; P < .001). Strictures were dilated to 15.5 +/- 0.4 mm. There were no perforations or clinically significant bleeding after dilation; 93% of the strictures were successfully managed with 1 or 2 endoscopic sessions. Dilation to at least 15 mm did not affect weight loss at 1 year when compared with the group without a stricture (percentage excess weight loss: stricture group, 76%; no stricture group, 74%). LIMITATIONS:Single-center, retrospective study. CONCLUSIONS:Endoscopic balloon dilation is a safe and effective method for the management of gastrojejunostomy strictures after Roux-en-Y gastric bypass. Dilation to at least 15 mm is safe and decreases the need for further endoscopic dilation.

journal_name

Gastrointest Endosc

journal_title

Gastrointestinal endoscopy

authors

Peifer KJ,Shiels AJ,Azar R,Rivera RE,Eagon JC,Jonnalagadda S

doi

10.1016/j.gie.2006.10.012

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

248-52

issue

2

eissn

0016-5107

issn

1097-6779

pii

S0016-5107(06)03115-4

journal_volume

66

pub_type

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