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Endoscopic dilation of gastrojejunal anastomotic strictures after laparoscopic gastric bypass. Predictors of initial failure.
Obes Surg. 2011 Jan; 21(1):36-41.OS

Abstract

BACKGROUND AND AIMS

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most frequent technique performed in bariatric surgery. Gastrojejunal anastomotic stricture is one of the most common postoperative complications. The aims of this study were to evaluate the efficacy and safety of endoscopic balloon dilation in the treatment of the gastrojejunal anastomotic strictures after LRYGB and to look for predicting factors that would indicate the need of repeated dilations.

METHODS

We included all patients with morbid obesity who underwent a LRYGB at our institution between January 2002 and July 2007. All patients who developed symptoms compatible with stricture of the gastrojejunostomy were referred to upper gastrointestinal endoscopy and underwent endoscopic balloon dilation.

RESULTS

One hundred and five out of the 1,330 patients (7.8%) developed an anastomotic stricture. The mean time to diagnosis was 3 months after the surgery. The mean diameter of the stricture was 5 mm. Sixty out of the 105 patients required only one dilation (57%), 29 required two dilations (27,6%), 13 required three dilations, and 3 patients underwent a fourth dilation. Clinical success was achieved in 100% of the cases, with an average of 1.6 dilations. The statistical analysis showed that only the time from surgery to stricture formation (p = 0.007) and the diameter achieved at the first dilation (p = 0.015) had statistical significance as predictors of the need of one or more dilations.

CONCLUSIONS

Endoscopic balloon dilation is a safe and effective method. Most of the patients are successfully managed with one or two dilations. The longer time from surgery to the appearance of symptoms ant the largest diameter achieved at the first dilation are the only predicting factors of success with only one dilation.

Authors+Show Affiliations

Endoscopy Unit, Centro Médico Teknon, Barcelona, Spain.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

20396992

Citation

Da Costa, Mariel, et al. "Endoscopic Dilation of Gastrojejunal Anastomotic Strictures After Laparoscopic Gastric Bypass. Predictors of Initial Failure." Obesity Surgery, vol. 21, no. 1, 2011, pp. 36-41.
Da Costa M, Mata A, Espinós J, et al. Endoscopic dilation of gastrojejunal anastomotic strictures after laparoscopic gastric bypass. Predictors of initial failure. Obes Surg. 2011;21(1):36-41.
Da Costa, M., Mata, A., Espinós, J., Vila, V., Roca, J. M., Turró, J., & Ballesta, C. (2011). Endoscopic dilation of gastrojejunal anastomotic strictures after laparoscopic gastric bypass. Predictors of initial failure. Obesity Surgery, 21(1), 36-41. https://doi.org/10.1007/s11695-010-0154-7
Da Costa M, et al. Endoscopic Dilation of Gastrojejunal Anastomotic Strictures After Laparoscopic Gastric Bypass. Predictors of Initial Failure. Obes Surg. 2011;21(1):36-41. PubMed PMID: 20396992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Endoscopic dilation of gastrojejunal anastomotic strictures after laparoscopic gastric bypass. Predictors of initial failure. AU - Da Costa,Mariel, AU - Mata,Alfredo, AU - Espinós,Jorge, AU - Vila,Victor, AU - Roca,Josep M, AU - Turró,Jesús, AU - Ballesta,Carlos, PY - 2010/4/17/entrez PY - 2010/4/17/pubmed PY - 2011/4/7/medline SP - 36 EP - 41 JF - Obesity surgery JO - Obes Surg VL - 21 IS - 1 N2 - BACKGROUND AND AIMS: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most frequent technique performed in bariatric surgery. Gastrojejunal anastomotic stricture is one of the most common postoperative complications. The aims of this study were to evaluate the efficacy and safety of endoscopic balloon dilation in the treatment of the gastrojejunal anastomotic strictures after LRYGB and to look for predicting factors that would indicate the need of repeated dilations. METHODS: We included all patients with morbid obesity who underwent a LRYGB at our institution between January 2002 and July 2007. All patients who developed symptoms compatible with stricture of the gastrojejunostomy were referred to upper gastrointestinal endoscopy and underwent endoscopic balloon dilation. RESULTS: One hundred and five out of the 1,330 patients (7.8%) developed an anastomotic stricture. The mean time to diagnosis was 3 months after the surgery. The mean diameter of the stricture was 5 mm. Sixty out of the 105 patients required only one dilation (57%), 29 required two dilations (27,6%), 13 required three dilations, and 3 patients underwent a fourth dilation. Clinical success was achieved in 100% of the cases, with an average of 1.6 dilations. The statistical analysis showed that only the time from surgery to stricture formation (p = 0.007) and the diameter achieved at the first dilation (p = 0.015) had statistical significance as predictors of the need of one or more dilations. CONCLUSIONS: Endoscopic balloon dilation is a safe and effective method. Most of the patients are successfully managed with one or two dilations. The longer time from surgery to the appearance of symptoms ant the largest diameter achieved at the first dilation are the only predicting factors of success with only one dilation. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/20396992/Endoscopic_dilation_of_gastrojejunal_anastomotic_strictures_after_laparoscopic_gastric_bypass__Predictors_of_initial_failure_ L2 - https://dx.doi.org/10.1007/s11695-010-0154-7 DB - PRIME DP - Unbound Medicine ER -