Endoscopic dilation of gastroesophageal anastomosis stricture after gastric bypass.
BACKGROUND
The management of strictures after gastric bypass procedure using balloon dilation is described.


METHODS
A retrospective review of all dilations performed is presented. Balloon dilators were used, and all strictures were dilated initially up to 12 to 15 mm for 1 min.


RESULTS
The review included 24 patients with a mean age of 42.8 years and a mean body mass index of 49.6. All the patients except one were women. In terms of procedure, 67% required one dilation and 30% required two. In the first 3 months after surgery, 21 patients developed the stricture. Three patients (13%) had leaks. There was no endoscopic appearance suggesting the need for a repeated procedure. All the dilations were successful, and weight loss compared well with that in the rest of the patients.


CONCLUSIONS
A successful technique for the treatment of anastomotic strictures after gastric bypass is presented. Most of the patients required one dilation. Most strictures appeared during the first 3 months after surgery. Female gender and leak may be high risk factors for the development of stricture.
Barba
C A
CA
Department of Surgery, Division of Minimally Invasive Surgery, Saint Francis Hospital and Medical Center, University of Connecticut, Hartford, USA. cbarba@stfranciscare.org
Butensky
M S
MS
Lorenzo
M
M
Newman
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D015992:Body Mass Index; D002404:Catheterization / Q000379:methods*; D003251:Constriction, Pathologic / Q000209:etiology / Q000628:therapy; D004940:Esophageal Stenosis / Q000209:etiology / Q000628:therapy*; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D005773:Gastroscopy; D005774:Gastrostomy / Q000009:adverse effects; D006801:Humans; D007582:Jejunostomy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013272:Stomach Diseases / Q000209:etiology / Q000628:therapy*