María Luisa García-García1, Juan Gervasio Martín-Lorenzo2, Ramón Lirón-Ruiz2, José Antonio Torralba-Martínez2, Alvaro Campillo-Soto2, Joana Miguel-Perelló2, Enrique Pérez-Cuadrado3, José Luis Aguayo-Albasini4. 1. Servicio de Cirugía General, Hospital General Universitario J. M. Morales Meseguer, Murcia, España. Electronic address: mlgrgr@gmail.com. 2. Servicio de Cirugía General, Hospital General Universitario J. M. Morales Meseguer, Murcia, España. 3. Sección de Gastroenterología y Endoscopia, Hospital General Universitario J. M. Morales Meseguer, Murcia, España. 4. Servicio de Cirugía General, Hospital General Universitario J. M. Morales Meseguer, Murcia, España; Departamento de Cirugía, Campus de Excelencia Internacional Mare Nostrum, Universidad de Murcia, Murcia, España.
Abstract
OBJECTIVE: Gastrojejunal stricture (GYS), not only is a common complication after laparoscopic gastric bypass, but its frequency is about 15% according to bibliography. Our aim is to present our experience after 280 laparoscopic gastric bypass. PATIENTS AND METHOD: From January 2004 to December 2012, 280 patients underwent a laparoscopic Roux en Y gastric bypass with creation of the gastrojejunal anastomosis is performed with circular stapler type CEAA No 21 in 265 patients and with a linear stapler in 15 patients. In all patients with persistent feeding intolerance were performed barium transit and/or gastroscopy. When gastrojejunal stricture showed proceeded to endoscopic pneumatic dilation. RESULTS: Twenty cases (7.1%) developed a gastrojejunal stricture, in 4 of these cases the initial diagnosis was made by barium transit and all case were confirmed by endoscopy. Five patients had a history of digestive bleeding that required endoscopic sclerosis of the bleeding lesion. All cases were resolved by endoscopic dilatation. One patient suffered a perforation and a re-intervention. At follow-up has not been detected re-stricture. CONCLUSION: Structure at the gastrojejunal anastomosis after gastric bypass is the commonest complication early after surgery. Endoscopic balloon dilatation is a safe and effective therapy.
OBJECTIVE: Gastrojejunal stricture (GYS), not only is a common complication after laparoscopic gastric bypass, but its frequency is about 15% according to bibliography. Our aim is to present our experience after 280 laparoscopic gastric bypass. PATIENTS AND METHOD: From January 2004 to December 2012, 280 patients underwent a laparoscopic Roux en Y gastric bypass with creation of the gastrojejunal anastomosis is performed with circular stapler type CEAA No 21 in 265 patients and with a linear stapler in 15 patients. In all patients with persistent feeding intolerance were performed barium transit and/or gastroscopy. When gastrojejunal stricture showed proceeded to endoscopic pneumatic dilation. RESULTS: Twenty cases (7.1%) developed a gastrojejunal stricture, in 4 of these cases the initial diagnosis was made by barium transit and all case were confirmed by endoscopy. Five patients had a history of digestive bleeding that required endoscopic sclerosis of the bleeding lesion. All cases were resolved by endoscopic dilatation. One patient suffered a perforation and a re-intervention. At follow-up has not been detected re-stricture. CONCLUSION: Structure at the gastrojejunal anastomosis after gastric bypass is the commonest complication early after surgery. Endoscopic balloon dilatation is a safe and effective therapy.
Authors: Lea Fayad; Cem Simsek; Roberto Oleas; Yervant Ichkhanian; Georges E Fayad; Saowanee Ngamreungphong; Michael Schweitzer; Andreas Oberbach; Anthony N Kalloo; Mouen A Khashab; Vivek Kumbhari Journal: Obes Surg Date: 2019-11 Impact factor: 4.129