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Chen W, Chen I, Chen T, Hsu M, Tsai Y, Tai C. Endoscopic balloon dilation for gastrojejunal anastomotic stricture after
Roux‐en‐Y
gastric bypass: A case series. ADVANCES IN DIGESTIVE MEDICINE 2021. [DOI: 10.1002/aid2.13280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Wen‐Hsu Chen
- Department of Internal Medicine E‐Da Hospital Kaohsiung Taiwan
| | - I‐Sung Chen
- Department of Internal Medicine E‐Da Hospital Kaohsiung Taiwan
| | - Tzu‐Haw Chen
- Department of Internal Medicine E‐Da Hospital Kaohsiung Taiwan
| | - Ming‐Hung Hsu
- Department of Internal Medicine E‐Da Hospital Kaohsiung Taiwan
| | - Ying‐Nan Tsai
- Department of Internal Medicine E‐Da Cancer Hospital Kaohsiung Taiwan
| | - Chi‐Ming Tai
- Department of Internal Medicine E‐Da Hospital Kaohsiung Taiwan
- School of Medicine College of Medicine, I‐Shou University Kaohsiung Taiwan
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2
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Endoscopic Dilation of Bariatric RNY Anastomotic Strictures: a Systematic Review and Meta-analysis. Obes Surg 2019; 28:4053-4063. [PMID: 30244332 DOI: 10.1007/s11695-018-3491-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Gastrojejunostomy anastomotic strictures are a complication of Roux-en-Y gastric bypass surgery without an established treatment guideline. A systematic review and meta-analysis were performed to determine the safety and efficacy of endoscopic dilation in their management. PubMed, Web of Science, and Cochrane Central (1994-2017) were searched. Data was analyzed with random effects meta-analysis and mixed effects meta-regression. Twenty-one observational studies (896 patients) were included. The stricture rate for laparoscopic patients was 6% (95% CI, 5-9%). Only 38% (95% CI, 30-47%) required greater than one dilation. Symptom improvement occurred in 97% (95% CI, 94-98%). The complication rate was 4% (95% CI, 3-6%). Endoscopic dilation of GJA strictures is safe, effective, and sustaining. This study can guide endoscopists in the treatment of a common bariatric surgical complication.
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Souto-Rodríguez R, Alvarez-Sánchez MV. Endoluminal solutions to bariatric surgery complications: A review with a focus on technical aspects and results. World J Gastrointest Endosc 2017; 9:105-126. [PMID: 28360973 PMCID: PMC5355758 DOI: 10.4253/wjge.v9.i3.105] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Revised: 10/12/2016] [Accepted: 12/14/2016] [Indexed: 02/06/2023] Open
Abstract
Obesity is a growing problem in developed countries, and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients. Despite the advances in surgical techniques, some patients still develop acute and late postoperative complications, and an endoscopic evaluation is often required for diagnosis. Moreover, the high morbidity related to surgical reintervention, the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery, and, in many cases, a suitable first-line treatment of bariatric surgery complications. There is now evidence in the literature supporting endoscopic management for some of these complications, such as gastrointestinal bleeding, stomal and marginal ulcers, stomal stenosis, leaks and fistulas or pancreatobiliary disorders. However, endoscopic treatment in this setting is not standardized, and there is no consensus on its optimal timing. In this article, we aim to analyze the secondary complications of the most expanded techniques of bariatric surgery with special emphasis on those where more solid evidence exists in favor of the endoscopic treatment. Based on a thorough review of the literature, we evaluated the performance and safety of different endoscopic options for every type of complication, highlighting the most recent innovations and including comparative data with surgical alternatives whenever feasible.
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Bisschops R, Areia M, Coron E, Dobru D, Kaskas B, Kuvaev R, Pech O, Ragunath K, Weusten B, Familiari P, Domagk D, Valori R, Kaminski MF, Spada C, Bretthauer M, Bennett C, Senore C, Dinis-Ribeiro M, Rutter MD. Performance measures for upper gastrointestinal endoscopy: A European Society of Gastrointestinal Endoscopy quality improvement initiative. United European Gastroenterol J 2016; 4:629-656. [PMID: 27733906 DOI: 10.1177/2050640616664843] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 07/22/2016] [Indexed: 12/14/2022] Open
Affiliation(s)
- Raf Bisschops
- Department of Gastroenterology and Hepatology, University Hospital Leuven, Leuven, Belgium
| | - Miguel Areia
- Gastroenterology Department, Portuguese Oncology Institute, Coimbra, Portugal; Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal
| | - Emmanuel Coron
- Institut des Maladies de l'Appareil Digestif, CHU de Nantes, Nantes, France
| | - Daniela Dobru
- Gastroenterology Department, University of Medicine and Pharmacy, Targu Mures, Romania
| | - Bernd Kaskas
- Department of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roman Kuvaev
- Endoscopy, Yaroslavl Regional Cancer Hospital, Yaroslavl, Russian Federation
| | - Oliver Pech
- Klinik für Gastroenterologie und interventionelle Endoskopie, Barmherzige Brüder Regensburg, Regensburg, Germany
| | - Krish Ragunath
- NIHR Nottingham Digestive Diseases Biomedical Research Unit, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, UK
| | - Bas Weusten
- Department of Gastroenterology and Hepatology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Pietro Familiari
- Digestive Endoscopy Unit, Agostino Gemelli University Hospital, Rome, Italy
| | - Dirk Domagk
- Department of Internal Medicine, Joseph's Hospital, Warendorf, Germany
| | - Roland Valori
- Department of Gastroenterology, Gloucestershire Hospitals NHS Foundation Trust, Gloucestershire, UK
| | - Michal F Kaminski
- Department of Health Management and Health Economy and KG Jebsen Centre for Colorectal Cancer, University of Oslo, Oslo, Norway; Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, and Medical Center for Postgraduate Education, Warsaw, Poland
| | - Cristiano Spada
- Digestive Endoscopy Unit, Agostino Gemelli University Hospital, Rome, Italy
| | - Michael Bretthauer
- Department of Health Management and Health Economy and KG Jebsen Centre for Colorectal Cancer, University of Oslo, Oslo, Norway; Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Cathy Bennett
- Centre for Technology Enabled Research, Coventry University, Coventry, UK
| | - Carlo Senore
- CPO Piemonte, AOU Città della Salute e della Scienza, Torino, Italy
| | - Mário Dinis-Ribeiro
- Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal; Servicio de Gastroenterologia, Instituto Portugues de Oncologia Francisco Gentil, Porto, Portugal
| | - Matthew D Rutter
- Department of Gastroenterology, University Hospital of North Tees, Stockton-on-Tees, UK; School of Medicine, Durham University, Durham, UK
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Malli CP, Sioulas AD, Emmanouil T, Dimitriadis GD, Triantafyllou K. Endoscopy after bariatric surgery. Ann Gastroenterol 2016; 29:249-57. [PMID: 27366025 PMCID: PMC4923810 DOI: 10.20524/aog.2016.0034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 04/08/2016] [Indexed: 12/16/2022] Open
Abstract
Obesity is a global epidemic with significant morbidity and mortality. Weight loss results in reduction of health risks and improvement in quality of life, thus representing a goal of paramount importance. Bariatric surgery is the most efficacious choice compared to conservative alternatives including diet, exercise, drugs and behavioral modification to treat obese patients. Following bariatric operations, patients may present with upper gastrointestinal tract complaints that warrant endoscopic evaluation and the various bariatric surgery types are often linked to complications. A subset of these complications necessitates endoscopic interventions for accurate diagnosis and effective, minimal invasive treatment. This review aims to highlight the role of upper gastrointestinal endoscopy in patients who have undergone bariatric surgery to evaluate and potentially treat surgery-related complications and upper gastrointestinal symptoms.
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Affiliation(s)
- Chrysoula P. Malli
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Athanasios D. Sioulas
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Theodoros Emmanouil
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - George D. Dimitriadis
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
| | - Konstantinos Triantafyllou
- Hepatogastroenterology Unit, Second Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University General Hospital, Medical School, National and Kapodistrian University, Athens, Greece
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da Rocha L, Ayub Pérez O, Arantes V. Endoscopic management of bariatric surgery complications: what the gastroenterologist should know. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO (ENGLISH EDITION) 2016. [DOI: 10.1016/j.rgmxen.2015.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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de Moura EGH, Orso IRB, Aurélio EF, de Moura ETH, de Moura DTH, Santo MA. Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis 2015; 12:582-586. [PMID: 27174245 DOI: 10.1016/j.soard.2015.11.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Revised: 11/02/2015] [Accepted: 11/11/2015] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Roux-en-Y gastric bypass is a commonly used technique of bariatric surgery. One of the most important complications is gastrojejunal anastomotic stricture. Endoscopic balloon dilation appears to be well tolerated and effective, but well-designed randomized, controlled trials have not yet been conducted. OBJECTIVE Identify factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. SETTING Gastrointestinal endoscopy service, university hospital, Brazil. METHODS The records of 64 patients with anastomotic stricture submitted to endoscopic dilation with hydrostatic balloon dilation were reviewed. Information was collected on gastric pouch length, anastomosis diameter before dilation, number of dilation sessions, balloon diameter at each session, anastomosis diameter after the last dilation session, presence of postsurgical complications, endoscopic complications, and outcome of dilation. Comparisons were made among postsurgical and endoscopic complications; number of dilations, balloon diameter; anastomosis diameter before dilation; and dilation outcome. RESULTS Success of dilation treatment was 95%. Perforation was positively and significantly associated with the number of dilation sessions (P = .03). Highly significant associations were found between ischemic segment and perforation (P<.001) and between ischemic segment and bleeding (P = .047). Ischemic segment (P = .02) and fistula (P = .032) were also associated with dilation failure. CONCLUSION Ischemic segment and fistula were found to be important risk factors for balloon dilation failure. The greater the number of dilation sessions, the greater the number of endoscopic complications.
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Affiliation(s)
- Eduardo G H de Moura
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Gastrointestinal Endoscopy Service, Hospital São Luiz Morumbi, São Paulo, Brazil
| | - Ivan R B Orso
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil; Gastroclínica Cascavel - Assis Gurgacz Medical School, Paraná, Brazil.
| | - Eduardo F Aurélio
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Eduardo T H de Moura
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Diogo T H de Moura
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
| | - Marco A Santo
- Gastrointestinal Endoscopy Service, Hospital das Clínicas, University of São Paulo Medical School, São Paulo, Brazil
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Endoscopic management of bariatric surgery complications: what the gastroenterologist should know. REVISTA DE GASTROENTEROLOGÍA DE MÉXICO 2015; 81:35-47. [PMID: 26552500 DOI: 10.1016/j.rgmx.2015.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 06/16/2015] [Accepted: 06/18/2015] [Indexed: 12/11/2022]
Abstract
Obesity is a serious disorder in almost the entire world. It is an important risk factor for a series of conditions that affect and threaten health. Currently, bariatric surgery is the most effective treatment for morbid obesity, and in addition to the resulting weight loss, it reduces morbidity in this population. There has been a significant increase in the number of obese patients operated on. Despite the success of bariatric surgery, an important group of patients still present with major postoperative complications. In order for endoscopy to effectively contribute to the diagnosis and treatment of complications deriving from obesity surgery, the gastroenterologist must be aware of the particularities involved in bariatric surgery. The present article is a review of the resulting anatomic aspects of the main surgical techniques employed, the most common postoperative symptoms, the potential complications, and the possibilities that endoscopic diagnosis and treatment offer. Endoscopy is a growing and continuously evolving method in the treatment of bariatric surgery complications. The aim of this review is to contribute to the preparation of gastroenterologists so they can offer adequate endoscopic diagnosis and treatment to this high-risk population.
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Estenosis de la anastomosis gastroyeyunal en el bypass gástrico laparoscópico. Experiencia en una serie de 280 casos en 8 años. Cir Esp 2014; 92:665-9. [DOI: 10.1016/j.ciresp.2014.06.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 06/06/2014] [Accepted: 06/10/2014] [Indexed: 11/22/2022]
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Medbery RL, Coefield R, Patel AD, Pettitt BJ, Singh A, Srinivasan JK, Woods K, Davis SS. Endoscopic Management of Gastrojejunostomy Strictures: One Institution's Approach. Bariatr Surg Pract Patient Care 2014. [DOI: 10.1089/bari.2014.0002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- Rachel L. Medbery
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Rebecca Coefield
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Ankit D. Patel
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Barbara J. Pettitt
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Arvinpal Singh
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | | | - Kevin Woods
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - S. Scott Davis
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia
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Campos JM, Mello FSTD, Ferraz AAB, Brito JND, Nassif PAN, Galvão-Neto MDP. Endoscopic dilation of gastrojejunal anastomosis after gastric bypass. ABCD-ARQUIVOS BRASILEIROS DE CIRURGIA DIGESTIVA 2013; 25:283-9. [PMID: 23411930 DOI: 10.1590/s0102-67202012000400014] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 04/17/2012] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Roux-en-Y gastric bypass may result in stenosis of the gastrojejunal anastomosis. There is currently no well-defined management protocol for this complication. AIM Through systematic review, to analyze the results of endoscopic dilation in patients with stenosis, including complication and success rates. METHODS The PubMed database was searched for relevant studies published each year from 1988 to 2010, and 23 studies were identified for analysis. Only papers describing the treatment of anastomotic stricture after Roux-en-Y gastric bypass were included, and case reports featuring less than three patients were excluded. RESULTS The mean age of the trial populations was 42.3 years and mean preoperative body mass index was 48.8 kg/m². A total of 1,298 procedures were undertaken in 760 patients (81% female), performing 1.7 dilations per patient. Through-the-scope balloons were used in 16 studies (69.5%) and Savary-Gilliard bougies in four. Only 2% of patients required surgical revision after dilation; the reported complication rate was 2.5% (n=19). Annual success rate was greater than 98% each year from 1992 to 2010, except for a 73% success rate in 2004. Seven studies reported complications, being perforation the most common, reported in 14 patients (1.82%) and requiring immediate operation in two patients. Other complications were also reported: one esophageal hematoma, one Mallory-Weiss tear, one case of severe nausea and vomiting, and two cases of severe abdominal pain. CONCLUSION Endoscopic treatment of stenosis is safe and effective; however, further high-quality randomized controlled trials should be conducted to confirm these findings.
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Espinel J, Pinedo E. Stenosis in gastric bypass: Endoscopic management. World J Gastrointest Endosc 2012; 4:290-5. [PMID: 22816008 PMCID: PMC3399006 DOI: 10.4253/wjge.v4.i7.290] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2011] [Revised: 05/02/2012] [Accepted: 07/01/2012] [Indexed: 02/05/2023] Open
Abstract
Gastric bypass is a treatment option for morbid obesity. Stenosis of the gastrojejunal anastomosis is a recognized complication. The pathophysiological mechanisms involved in the formation of stenosis are not well known. Gastrojejunal strictures can be classified based on time of onset, mechanism of formation, and endoscopic aspect. Diagnosis is usually obtained by endoscopy. The two main treatment alternatives for stomal stricture are: endoscopic dilatation (balloon or bouginage) and surgical revision (open or laparoscopic). Both techniques of dilation [through-the-scope (TTS) balloon dilators, Bougienage dilators] are considered safe, effective, and do not require hospitalization. The optimal technique for dilation of stomal strictures remains to be determined, but many authors prefer the use of TTS balloon catheters. Most patients can be successfully treated with 1 or 2 sessions. The need for reconstructive surgery of a stomal stricture is extremely rare.
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Affiliation(s)
- Jesús Espinel
- Jesús Espinel, Endoscopy Unit, Gastroenterology Department, Hospital de León, 24071 León, Spain
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Gill RS, Whitlock KA, Mohamed R, Birch DW, Karmali S. Endoscopic Treatment Options in Patients With Gastrojejunal Anastomosis Stricture Following Roux-en-Y Gastric Bypass. Gastroenterology Res 2012; 5:1-5. [PMID: 27785171 PMCID: PMC5051034 DOI: 10.4021/gr385w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2012] [Indexed: 12/16/2022] Open
Abstract
The proportion of obese individuals continues to increase worldwide. Bariatric surgery remains the only evidence-based treatment strategy to produce marked weight loss. Roux-en-Y gastric bypass is an effective and common bariatric surgical procedure offered to obese patients. However, a small percentage of individuals can develop narrowing or stricture formation of the gastrojejunal anastomosis. Endoscopic treatment of gastrojejunostomy (GJ) is preferred compared to surgical revision, as it is less invasive. The endoscopic treatment strategy most common employed is balloon dilatation. Endoscopic balloon dilatation is successful in majority of cases with low morbidity, however multiple dilatation may be required. Other endoscopic strategies such as incisional therapy has been successful in treating other gastrointestinal anastomotic strictures, however remain to be evaluated in post-RYGB GJ strictures. Further research is needed to determine the effectiveness of incision therapy and other endoscopic treatment strategies compared to endoscopic balloon dilatation.
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Affiliation(s)
- Richdeep S Gill
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Richdeep S. Gill and Kevin A. Whitlock were co-first authors
| | - Kevin A Whitlock
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Richdeep S. Gill and Kevin A. Whitlock were co-first authors
| | - Rachid Mohamed
- Division of Gastroenterology, University of Calgary, Calgary, Alberta, Canada
| | - Daniel W Birch
- Center of the Advancement of Minimally Invasive Surgery (CAMIS), Royal Alexandria Hospital, Edmonton, Alberta, Canada
| | - Shahzeer Karmali
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
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Gill RS, Whitlock KA, Mohamed R, Sarkhosh K, Birch DW, Karmali S. The role of upper gastrointestinal endoscopy in treating postoperative complications in bariatric surgery. JOURNAL OF INTERVENTIONAL GASTROENTEROLOGY 2012; 2:37-41. [PMID: 22586549 DOI: 10.4161/jig.20133] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 12/21/2011] [Accepted: 12/23/2011] [Indexed: 12/17/2022]
Abstract
There are an estimated 500 million obese individuals worldwide. Currently, bariatric surgery has been shown to result in clinically significant weight loss. With increasing demand for bariatric surgery, endoscopic techniques used intra and postoperatively continue to evolve. Endoscopic evaluation of anastomotic integrity following RYGB allows for early detection of anastomotic leaks. Furthermore, endoscopy is a valuable tool to diagnose and treat RYGB postoperative surgical complications such as anastomotic leakage, hemorrhage and stricture formation. Early evidence suggests that endoscopic management of upper gastrointestinal hemorrhage following RYGB is effective. In addition, endoscopic balloon dilatation is able to effectively treat obstruction in the setting of gastrojejunal anastomotic strictures. With successful endoscopic management of these complications, bariatric patients may avoid more invasive surgical procedures.
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Affiliation(s)
- Richdeep S Gill
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
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Intraoperative Endoscopic Assessment of the Pouch and Anastomosis During Laparoscopic Roux-en-Y Gastric Bypass. Obes Surg 2011; 21:1530-4. [DOI: 10.1007/s11695-011-0355-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Double stapling Roux-en-Y reconstruction in a laparoscopy-assisted distal gastrectomy. Surg Today 2010; 40:943-8. [DOI: 10.1007/s00595-009-4188-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 08/31/2009] [Indexed: 01/15/2023]
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17
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Potack J. Management of post bariatric surgery anastomotic strictures. TECHNIQUES IN GASTROINTESTINAL ENDOSCOPY 2010. [DOI: 10.1016/j.tgie.2010.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
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