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

Espinel, Jesús; de-la-Cruz, José Luis; Pinedo, Eugenia; Canga, José Carlos; de-la-Cruz, Felipe

doi:10.4321/s1130-01082011001000002

Cited by 11 publications

(2 citation statements)

References 16 publications

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“…Although the use of fluoroscopy is advisable to avoid entry into the blind limb in cases of non-traversable stenosis with the gastroscope, balloon dilation without fluoroscopy guidance has been reported to be safe. In a series of 22 patients with a stomal stenosis, balloon dilation was performed without fluoroscopy and achieved a success rate of 100% without any perforation[35]. Based on these results, the authors concluded that fluoroscopy is not always required for positioning the balloon and recommended the use of fluoroscopy liberally in difficult cases.…”

Section: Stomal Stenosesmentioning

confidence: 99%

“…Overall, the most recent studies in the literature have reported a success rate higher than 90% with very few complications (Table 1)[35-46]. It is important to note that in one study reporting on balloon dilation in 72 gastrojejunal strictures after RYGB, late strictures (> 90 d after RYGB) were found to have an inferior rate of response to endoscopic dilation (61% vs 98%) and often required revisional surgery[46].…”

Section: Stomal Stenosesmentioning

confidence: 99%

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Endoluminal solutions to bariatric surgery complications: A review with a focus on technical aspects and results

Souto-Rodríguez¹,

Alvarez-Sánchez²

2017

WJGE

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Obesity is a growing problem in developed countries, and surgery is the most effective treatment in terms of weight loss and improving medical comorbidity in a high proportion of obese patients. Despite the advances in surgical techniques, some patients still develop acute and late postoperative complications, and an endoscopic evaluation is often required for diagnosis. Moreover, the high morbidity related to surgical reintervention, the important enhancement of endoscopic procedures and technological innovations introduced in endoscopic equipment have made the endoscopic approach a minimally-invasive alternative to surgery, and, in many cases, a suitable first-line treatment of bariatric surgery complications. There is now evidence in the literature supporting endoscopic management for some of these complications, such as gastrointestinal bleeding, stomal and marginal ulcers, stomal stenosis, leaks and fistulas or pancreatobiliary disorders. However, endoscopic treatment in this setting is not standardized, and there is no consensus on its optimal timing. In this article, we aim to analyze the secondary complications of the most expanded techniques of bariatric surgery with special emphasis on those where more solid evidence exists in favor of the endoscopic treatment. Based on a thorough review of the literature, we evaluated the performance and safety of different endoscopic options for every type of complication, highlighting the most recent innovations and including comparative data with surgical alternatives whenever feasible.

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Section: Stomal Stenosesmentioning

confidence: 99%