Successful management of gastrojejunal strictures after gastric bypass: is timing important?

Yimcharoen, Panot; Heneghan, Helen; Chand, Bipan; Talarico, Joseph; Tariq, Nabil; Kroh, Matthew; Brethauer, Stacy A.

doi:10.1016/j.soard.2011.01.043

Cited by 59 publications

(24 citation statements)

References 31 publications

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“…While surgical revision has traditionally been used to treat weight regain, the procedure is associated with limited efficacy data and higher complication rates than that of the index surgery. [27][28][29][30] Alternatively, endoscopic techniques have recently been developed to treat weight regain. These include sclerotherapy where sodium morrhuate is injected around the GJA to reduce the GJA size, 31 32 argon plasma coagulation, 33 34 endoscopic plication and endoscopic suturing to close a small gastrogastric fistula and/or to reduce the size of the GJA.…”

Section: Discussionmentioning

confidence: 99%

Weight regain after Roux-en-Y gastric bypass has a large negative impact on the Bariatric Quality of Life Index

Jirapinyo

Dayyeh

Thompson

2017

BMJ Open Gastroenterol

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BackgroundDespite initial successful weight loss, some patients may experience weight regain following Roux-en-Y gastric bypass (RYGB).ObjectiveTo assess the impact of weight regain on bariatric patients’ quality of life (QoL).MethodsThis was a prospective cross-sectional study. Fifty-six consecutive RYGB patients were recruited and divided into weight-regain and weight-stable cohorts. QoL was assessed using the Bariatric Quality of Life (BQL) questionnaire. The BQL Index scores of the weight-regain and weight-stable groups were compared using Student’s t-test. Additionally, the BQL Index score of the weight-regain group was compared with that of historical prebariatric patients. Predictors of BQL were assessed using univariate and multivariate linear regression analyses.ResultsOf 56 RYGB patients, 41 (73%) had weight regain. On average, patients had body mass index (BMI) of 37 ±7.5 kg/m2 and gained 34 ±26% of maximal weight initially lost. Weight-regain patients had lower BQL Index scores than weight-stable patients (44.8±6 vs 53±7, p<0.001). Patients with weight regain had similar BQL Index scores as the prebariatric patients despite lower BMI (BMI of 39.7±6.8 vs 47.2±7.6, p<0.05; BQL Index of 44.8±6 vs 41.6±10.4, p=0.144, respectively). Years from RYGB, BMI and amount of weight regain were associated with BQL Index on a univariate analysis (β=−0.55,−0.52, −0.7; p<0.0001). Only weight regain was a significant predictor of BQL on a multivariate analysis (β =−0.56; p=0.001).ConclusionWeight regain had a negative impact on bariatric patients’ QoL. Patients who regained at least 15% of maximal weight lost appeared to have as low QoL as those who had not undergone bariatric surgery despite a lower BMI.

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Section: Discussionmentioning

confidence: 99%

Weight regain after Roux-en-Y gastric bypass has a large negative impact on the Bariatric Quality of Life Index

Jirapinyo

Dayyeh

Thompson

2017

BMJ Open Gastroenterol

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“…The incidence of gastrojejunal anastomotic stricture is about 10% and possible mechanisms include ischemia, excessive scarring, recurrent marginal ulcer and technical considerations such as excessive tension or torsion of the anastomosis. Endoscopy is the preferred tool for both diagnosis and treatment of gastrojejunal stricture (31). Gastrointestinal bleeding after RYGB is another uncommon late complication, typically caused by marginal ulceration.…”

Section: Complications Of Metabolic Surgerymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery

Corcelles

Daigle

Schauer

2016

European Journal of Endocrinology

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Obesity is associated with an increased risk of type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, osteoarthritis, numerous cancers and increased mortality. It is estimated that at least 2.8 million adults die each year due to obesity-related cardiovascular disease. Increasing in parallel with the global obesity problem is metabolic syndrome, which has also reached epidemic levels. Numerous studies have demonstrated that bariatric surgery is associated with significant and durable weight loss with associated improvement of obesity-related comorbidities. This review aims to summarize the effects of bariatric surgery on the components of metabolic syndrome (hyperglycemia, hyperlipidemia and hypertension), weight loss, perioperative morbidity and mortality, and the long-term impact on cardiovascular risk and mortality.

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“…Often, serial dilations every 2-3 weeks are needed to achieve patency (should not exceed 15 mm) and to minimize the risk of perforation [21][22][23]. Yimcharoen et al [24] demonstrated that early (<90 days) strictures had a superior response rate with balloon dilation than late (>90 days) strictures (98 versus 61%, P < 0.001). If balloon dilation is unsuccessful, then endoscopic incision (2-3 cuts) using a papillotome prior to balloon dilation can be attempted [20].…”

Section: Strictures and Functional Stenosesmentioning

confidence: 99%