Outcome of endoscopic balloon dilation of strictures after laparoscopic gastric bypass

Ukleja, Andrew; Afonso, Bianca; Pimentel, Ronnie; Szomstein, Samuel; Rosenthal, Raúl J.

doi:10.1007/s00464-008-9788-0

Cited by 136 publications

(76 citation statements)

References 23 publications

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“…Of the 18 studies describing the method of anastomosis, 12 (70.5%) used a circular stapler and, five of them, also used either manual suturing 20,24 or a linear stapler 17,28,29 . Four studies used a linear stapler only 4,18,22,26 and one study used manual suturing only 11 .…”

Section: Resultsmentioning

confidence: 99%

Dilatação endoscópica de anastomose gastrojejunal após bypass gástrico

Campos

Mello

Ferraz

et al. 2012

ABCD, arq. bras. cir. dig.

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-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. ABCDDV/885RESUMO -Introdução -Bypass gástrico em Y-de-Roux pode resultar em estenose de anastomose gastrojejunal. Não há protocolo de tratamento bem definido para essa complicação. Objetivo -Analisar os resultados da dilatação endoscópica em pacientes com estenose, através de revisão sistemática, incluindo complicações e taxa de sucesso.

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Section: Resultsmentioning

confidence: 99%

Dilatação endoscópica de anastomose gastrojejunal após bypass gástrico

Campos

Mello

Ferraz

et al. 2012

ABCD, arq. bras. cir. dig.

View full text Add to dashboard Cite

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“…Some authors have obtained good results by Savary-Gilliard bougies (11). Although most prefer the use of through-the-scope (TTS) (4,5,8,10,12,(14)(15)(16)(17)(18). Our experience shows that the dilation of the stenosis of the stoma using TTS balloon is safe and effective.…”

Section: Discussionmentioning

confidence: 79%

“…Published studies are not clear when it comes to describing this aspect. The minority of them clearly manifest not using fluoroscopy during dilation (4,18), others claim to have used it in all or in one of their patients (5,6,8,11,16), and finally, others do not make any sort of comment in this regard in their publications (9,10,14,15,17). Our experience demonstrates that carrying out dilations in patients with stenosis of the anastomosis in the gastric bypass is possible without a fluoroscopic guidance, allowing carrying out the technique in the simplest manner, in the same endoscopy room, without radiation for the patient or for the medical staff, and probably for a shorter period of time.…”

Section: Discussionmentioning

confidence: 99%

“…The stenosis of the stoma (stenosis of the gastro-jejunal anastomosis) occurs in approximately 3-12% after gastric bypass, and must be suspected when the patient experiences dysphagia, nausea and vomiting (2)(3)(4)(5)(6)(7)(8)(9). Endoscopic dilation of the stenosis by means of a balloon or bougie is considered the treatment of choice, even if in most studies it is not quite clear whether it should be done with or without a radioscopic guidance (4)(5)(6)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) In this study, we informed of our experience in the management of the stenosis of the stoma in patients with laparoscopic gastric bypass by means of endoscopic dilation with a hydrostatic balloon, without fluoroscopic guidance.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Stenosis in laparoscopic gastric bypass: management by endoscopic dilation without fluoroscopic guidance

Espinel¹,

de-la-Cruz²,

Pinedo³

et al. 2011

Rev. esp. enferm. dig.

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“…Dilation was done in 1 to 5 sessions and it was successful in all patients without a need for surgical revision. However, the procedure was complicated by perforation in 2.2% of all dilations (3 patients) [35]. In another series by Go et al which included 38 patients with stomal stenosis after RYGBP, the success rate of endoscopic balloon dilation was 95% with a 3% complication rate [36].…”

Section: Endoscopy In the Treatment Of Bariatric Surgery Complicationsmentioning

confidence: 97%