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Low anastomotic stricture rate after Roux-en-Y gastric bypass using a 21-mm circular stapling device.
Obes Surg. 2012 Sep; 22(9):1491-5.OS

Abstract

BACKGROUND

Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as a safe and effective procedure for morbid obesity management. Amongst some of the postoperative complications are gastrojejunal (GJ) anastomotic strictures, with an incidence of 3 to 27 % in some series. This study evaluates the incidence of GJ strictures using a 21-mm circular stapling device and its response to treatment with endoscopic balloon dilation.

METHODS

A retrospective chart review was conducted of patients who underwent LRYGB between January 2007 and September 2010. We used our previously published technique of retrocolic, retrogastric Roux-en-Y bypass, using a 21-mm circular stapler to construct the gastrojejunostomy. Postoperatively, patients with persistent food intolerance underwent an endoscopy. Those found to have a GJ stricture (defined as inability to pass the endoscope beyond he anastomotic site) underwent pneumatic dilation with a 12-mm balloon.

RESULTS

A total of 338 patients underwent LRYGB. Median follow-up was 57.6 weeks (8-137). Twenty-two patients underwent an endoscopy due to food intolerance. Sixteen patients (4.7 %, 16/338) were identified with GJ stricture and received at least one endoscopic dilation. The other six patients had a normal endoscopic evaluation. GJ strictures presented at an average of 35 days (13 to 90 days) postoperatively. Four patients underwent two endoscopic interventions, and one underwent three endoscopic interventions.

CONCLUSIONS

We hereby demonstrate that the construction of GJ anastomosis with a 21-mm circular stapler is associated with a low stricture rate using our standardized technique. Strictures are amenable to balloon dilatation with subsequent long-term resolution of symptoms.

Authors+Show Affiliations

University of California at San Diego, San Diego, CA 92103, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

eng

PubMed ID

22714823

Citation

Rondan, A, et al. "Low Anastomotic Stricture Rate After Roux-en-Y Gastric Bypass Using a 21-mm Circular Stapling Device." Obesity Surgery, vol. 22, no. 9, 2012, pp. 1491-5.
Rondan A, Nijhawan S, Majid S, et al. Low anastomotic stricture rate after Roux-en-Y gastric bypass using a 21-mm circular stapling device. Obes Surg. 2012;22(9):1491-5.
Rondan, A., Nijhawan, S., Majid, S., Martinez, T., & Wittgrove, A. C. (2012). Low anastomotic stricture rate after Roux-en-Y gastric bypass using a 21-mm circular stapling device. Obesity Surgery, 22(9), 1491-5. https://doi.org/10.1007/s11695-012-0671-7
Rondan A, et al. Low Anastomotic Stricture Rate After Roux-en-Y Gastric Bypass Using a 21-mm Circular Stapling Device. Obes Surg. 2012;22(9):1491-5. PubMed PMID: 22714823.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low anastomotic stricture rate after Roux-en-Y gastric bypass using a 21-mm circular stapling device. AU - Rondan,A, AU - Nijhawan,S, AU - Majid,S, AU - Martinez,Tracy, AU - Wittgrove,Alan C, PY - 2012/6/21/entrez PY - 2012/6/21/pubmed PY - 2013/1/4/medline SP - 1491 EP - 5 JF - Obesity surgery JO - Obes Surg VL - 22 IS - 9 N2 - BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (LRYGB) has been established as a safe and effective procedure for morbid obesity management. Amongst some of the postoperative complications are gastrojejunal (GJ) anastomotic strictures, with an incidence of 3 to 27 % in some series. This study evaluates the incidence of GJ strictures using a 21-mm circular stapling device and its response to treatment with endoscopic balloon dilation. METHODS: A retrospective chart review was conducted of patients who underwent LRYGB between January 2007 and September 2010. We used our previously published technique of retrocolic, retrogastric Roux-en-Y bypass, using a 21-mm circular stapler to construct the gastrojejunostomy. Postoperatively, patients with persistent food intolerance underwent an endoscopy. Those found to have a GJ stricture (defined as inability to pass the endoscope beyond he anastomotic site) underwent pneumatic dilation with a 12-mm balloon. RESULTS: A total of 338 patients underwent LRYGB. Median follow-up was 57.6 weeks (8-137). Twenty-two patients underwent an endoscopy due to food intolerance. Sixteen patients (4.7 %, 16/338) were identified with GJ stricture and received at least one endoscopic dilation. The other six patients had a normal endoscopic evaluation. GJ strictures presented at an average of 35 days (13 to 90 days) postoperatively. Four patients underwent two endoscopic interventions, and one underwent three endoscopic interventions. CONCLUSIONS: We hereby demonstrate that the construction of GJ anastomosis with a 21-mm circular stapler is associated with a low stricture rate using our standardized technique. Strictures are amenable to balloon dilatation with subsequent long-term resolution of symptoms. SN - 1708-0428 UR - https://www.unboundmedicine.com/medline/citation/22714823/Low_anastomotic_stricture_rate_after_Roux_en_Y_gastric_bypass_using_a_21_mm_circular_stapling_device_ L2 - https://dx.doi.org/10.1007/s11695-012-0671-7 DB - PRIME DP - Unbound Medicine ER -