Gianfranco Donatelli1, Jean-Loup Dumont2, Guillame Pourcher3, Hadrien Tranchart3, Thierry Tuszynski2, Ibrahim Dagher3, Jean-Marc Catheline4, Renaud Chiche5, Jean-Pierre Marmuse6, Stavros Dritsas7, Bertrand-Marie Vergeau2, Bruno Meduri2. 1. Unité d'Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Paris, France. Electronic address: donatelligianfranco@gmail.com. 2. Unité d'Endoscopie Interventionnelle, Hôpital Privé des Peupliers, Paris, France. 3. Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris Descartes University, Paris, France. 4. Service de Chirurgie Viscérale, Centre Hôspitalier de Saint-Denis, Saint-Denis, France. 5. Service de Chirurgie Viscérale, Clinique Geoffry Sant Hilaire, Ramsay Générale de Santé, Paris, France. 6. Service de Chirurgie Digestive et Viscérale, Hôpital Universitaire Bichat - Claude Bernard - AP-HP, Paris, France. 7. Service de Gastroenterologie, Hôpital René Dubos, Pontoise, France.
Abstract
BACKGROUND: A large number of patients who undergo laparoscopic sleeve gastrectomy present with surgical complications. Stenosis, in particular, occurs in .7%-4% of cases. OBJECTIVES: To report our experience, results, and long-term follow-up after pneumatic dilation of late functional helix stenosis after laparoscopic sleeve gastrectomy. SETTING: Multicenter study led by an endoscopic tertiary referral center. METHODS: Thirty-five patients were dilated initially at 30 mm. Thirteen out of 35 patients underwent a second dilation up to 35 mm. Only 8 patients underwent a third pneumatic dilation up to 40 mm. The stricture was localized in the mid-body of the sleeve in 32 patients overall; 3 had narrowing adjacent to the cardia. Eleven twists formed an acute angle between the 2 segments of the stomach, whereas 24 angles were obtuse. Seven out of 35 patients presented with persistent dilated pouch above the twist. Two patients were lost to follow-up. Overall outcome at an average follow-up of 15.5 months after primary surgery (range 7-49 mo) was as follows: 12 clinical failures and 1 technical failure (40%) and 60% (20 out of 33) clinical success. CONCLUSION: Pneumatic dilation of late functional helix stricture is an effective technique for treatment of dysphagia in the majority of patients treated. Complete helix stricture, defined in function of the angle within twist, as well as the presence of a persistently dilated gastric pouch above the kinking, seems to be correlated with higher failure rates.
BACKGROUND: A large number of patients who undergo laparoscopic sleeve gastrectomy present with surgical complications. Stenosis, in particular, occurs in .7%-4% of cases. OBJECTIVES: To report our experience, results, and long-term follow-up after pneumatic dilation of late functional helix stenosis after laparoscopic sleeve gastrectomy. SETTING: Multicenter study led by an endoscopic tertiary referral center. METHODS: Thirty-five patients were dilated initially at 30 mm. Thirteen out of 35 patients underwent a second dilation up to 35 mm. Only 8 patients underwent a third pneumatic dilation up to 40 mm. The stricture was localized in the mid-body of the sleeve in 32 patients overall; 3 had narrowing adjacent to the cardia. Eleven twists formed an acute angle between the 2 segments of the stomach, whereas 24 angles were obtuse. Seven out of 35 patients presented with persistent dilated pouch above the twist. Two patients were lost to follow-up. Overall outcome at an average follow-up of 15.5 months after primary surgery (range 7-49 mo) was as follows: 12 clinical failures and 1 technical failure (40%) and 60% (20 out of 33) clinical success. CONCLUSION:Pneumatic dilation of late functional helix stricture is an effective technique for treatment of dysphagia in the majority of patients treated. Complete helix stricture, defined in function of the angle within twist, as well as the presence of a persistently dilated gastric pouch above the kinking, seems to be correlated with higher failure rates.
Authors: Luciana T Siqueira; Fernando Santa-Cruz; João Paulo Pontual; Maria Amélia R Aquino; Luca T Dompieri; Flávio Kreimer; Álvaro A B Ferraz Journal: Arq Bras Cir Dig Date: 2022-06-24
Authors: Laura Mazer; Jessica X Yu; Sean Bhalla; Kevin Platt; Lydia Watts; Sarah Volk; Allison R Schulman Journal: Obes Surg Date: 2022-04-05 Impact factor: 3.479
Authors: Belinda De Simone; Elie Chouillard; Almino C Ramos; Gianfranco Donatelli; Tadeja Pintar; Rahul Gupta; Federica Renzi; Kamal Mahawar; Brijesh Madhok; Stefano Maccatrozzo; Fikri M Abu-Zidan; Ernest E Moore; Dieter G Weber; Federico Coccolini; Salomone Di Saverio; Andrew Kirkpatrick; Vishal G Shelat; Francesco Amico; Emmanouil Pikoulis; Marco Ceresoli; Joseph M Galante; Imtiaz Wani; Nicola De' Angelis; Andreas Hecker; Gabriele Sganga; Edward Tan; Zsolt J Balogh; Miklosh Bala; Raul Coimbra; Dimitrios Damaskos; Luca Ansaloni; Massimo Sartelli; Nikolaos Parasas; Yoram Kluger; Elias Chahine; Vanni Agnoletti; Gustavo Fraga; Walter L Biffl; Fausto Catena Journal: World J Emerg Surg Date: 2022-09-27 Impact factor: 8.165