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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.

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Authors+Show Affiliations

Peifer KJ
Division of Gastroenterology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Shiels AJ
No affiliation info available
Azar R
No affiliation info available
Rivera RE
No affiliation info available
Eagon JC
No affiliation info available
Jonnalagadda S
No affiliation info available

MeSH

AdultAnastomosis, Roux-en-YCatheterizationConstriction, PathologicEndoscopy, GastrointestinalFemaleGastric BypassHumansLaparoscopyMaleMiddle AgedObesity, Morbid

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 -