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Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass.
Gastrointest Endosc. 2007 Aug; 66(2):248-52.GE

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.

Authors+Show Affiliations

Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17451700

Citation

Peifer, Kevin J., et al. "Successful Endoscopic Management of Gastrojejunal Anastomotic Strictures After Roux-en-Y Gastric Bypass." Gastrointestinal Endoscopy, vol. 66, no. 2, 2007, pp. 248-52.
Peifer KJ, Shiels AJ, Azar R, et al. Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass. Gastrointest Endosc. 2007;66(2):248-52.
Peifer, K. J., Shiels, A. J., Azar, R., Rivera, R. E., Eagon, J. C., & Jonnalagadda, S. (2007). Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass. Gastrointestinal Endoscopy, 66(2), 248-52.
Peifer KJ, et al. Successful Endoscopic Management of Gastrojejunal Anastomotic Strictures After Roux-en-Y Gastric Bypass. Gastrointest Endosc. 2007;66(2):248-52. PubMed PMID: 17451700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful endoscopic management of gastrojejunal anastomotic strictures after Roux-en-Y gastric bypass. AU - Peifer,Kevin J, AU - Shiels,Aaron J, AU - Azar,Riad, AU - Rivera,Ramon E, AU - Eagon,J Chris, AU - Jonnalagadda,Sreenivasa, Y1 - 2007/04/23/ PY - 2006/06/16/received PY - 2006/10/05/accepted PY - 2007/4/25/pubmed PY - 2007/10/17/medline PY - 2007/4/25/entrez SP - 248 EP - 52 JF - Gastrointestinal endoscopy JO - Gastrointest. Endosc. VL - 66 IS - 2 N2 - 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. SN - 0016-5107 UR - https://www.unboundmedicine.com/medline/citation/17451700/Successful_endoscopic_management_of_gastrojejunal_anastomotic_strictures_after_Roux_en_Y_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5107(06)03115-4 DB - PRIME DP - Unbound Medicine ER -