Stricture dilation after laparoscopic Roux-en-Y gastric bypass.
BACKGROUND
In surgical treatment of morbid obesity, maintaining a restrictive anastomosis is key to long-range success. However, laparoscopic Roux-en-Y gastric bypass (LRYGB) may result in gastrojejunal (GJ) stricture, requiring treatment in up to 27% of patients.


METHODS
This is a retrospective review of the outcome of 223 consecutive LRYGB patients. Patients developing stricture received standard endoscopic balloon dilation by the same surgeon. Stricture and nonstricture groups were compared for excess body weight loss (EBWL) at 1, 3, 6, and 12 months.


RESULTS
GJ stricture requiring dilation occurred in 38 patients (17%). After dilation all patients were relieved of stricture symptoms and none required revision. By 12 months, patients with stricture had an EBWL of 86% compared with nonstrictured patients at 75%.


CONCLUSIONS
Endoscopic balloon dilation is a safe and effective treatment option for GJ stricture. Improved weight loss occurred for patients with stricture requiring dilation.
Rossi
Thomas R
TR
Department of Surgery, University of Illinois College of Medicine at Peoria, 624 N.E. Glen Oak Ave., Peoria, IL 61603-3135, USA.
Dynda
Danuta I
DI
Estes
Norman C
NC
Marshall
J Stephen
JS
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects; D002404:Catheterization; D003251:Constriction, Pathologic / Q000209:etiology / Q000473:pathology / Q000628:therapy; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007579:Jejunal Diseases / Q000209:etiology* / Q000473:pathology / Q000628:therapy*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome