Gastrojejunal strictures following laparoscopic Roux-en-Y gastric bypass for morbid obesity

D. Goitein, P. K. Papasavas, D. Gagné, S. Ahmad, P. F. Caushaj

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Gastrojejunal strictures following laparoscopic Roux-en-Y gastric bypass (LRYGBP) present with dysphagia, nausea, and vomiting. Diagnosis is made by endoscopy and/or radiographic studies. Therapeutic options include endoscopic dilation and surgical revision. Methods: Of 369 LRYGBP performed, 19 patients developed anastomotic stricture (5.1%). One additional patient was referred from another facility. Pneumatic balloons were used for initial dilation in all patients. Savary-Gilliard bougies were used for some of the subsequent dilations. Results: Flexible endoscopy was diagnostic in all 20 patients allowing dilation in 18 (90%). Two patients did not undergo endoscopic dilation because of anastomotic obstruction and ulcer. The median time to stricture development was 32 days (range: 17-85). Most patients (78%) required more than two dilations. The complication rate was 1.6% (one case of microperforation). At a mean follow-up of 21 months, all patients were symptom-free. Conclusions: Gastrojejunostomy stricture following LRYGBP is associated with substantial morbidity and patient dissatisfaction. Based on our experience, we propose a clinical grading system and present our strategy for managing gastrojejunal strictures.

Original languageEnglish
Pages (from-to)628-632
Number of pages5
JournalSurgical Endoscopy and Other Interventional Techniques
Volume19
Issue number5
DOIs
StatePublished - May 2005
Externally publishedYes

Keywords

  • Bariatric surgery
  • Dilation
  • Endoscopy
  • Gastric bypass
  • Morbid obesity
  • Strictures

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