Format

Send to

Choose Destination
Surg Endosc. 2005 May;19(5):628-32. Epub 2005 Mar 11.

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

Author information

1
Department of Surgery, The Western Pennsylvania Hospital, 4800 Friendship Avenue, Pittsburgh, PA, USA.

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.

PMID:
15759176
DOI:
10.1007/s00464-004-9135-z
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center