title: Gastric Stenosis After Laparoscopic Sleeve Gastrectomy: Diagnosis and Management.
abstract: OBJECTIVE
  The use of laparoscopic sleeve gastrectomy (LSG) is increasing worldwide. Although post-LSG gastric stenosis (GS) is less frequent, it has not been well defined and lacks standardized management procedures. The objective of the present study was to describe a series of patients with GS symptoms after LSG and to develop a standardized management procedure for this complication.
  
  
  METHODS
  We performed a retrospective analysis of a prospective database of patients presenting with GS after LSG procedures performed between January 2008 and March 2014. The primary efficacy criterion was the frequency of post-LSG GS. GS was classified as functional (i.e. a gastric twist) or organic. The secondary efficacy criteria included the time interval between LSG and diagnosis of GS, the type of stenosis, the type of management, and the follow-up data.
  
  
  RESULTS
  During the study period, 1210 patients underwent primary or secondary LSG. Seventeen patients had post-operative symptoms of GS (1.4%); one patient had achalasia that had not been diagnosed preoperatively and thus was excluded from our analysis. The median time interval between LSG and diagnosis of GS was 47.2 days (1-114). Eleven patients had organic GS and six had functional GS. Seven patients required nutritional support. Endoscopic treatment was successful in 15 patients (88.2%) after balloon dilatation (n = 13) or insertion of a covered stent (n = 2). Two of the 15 patients required conversion to Roux-en-Y gastric bypass (11.8%).
  
  
  CONCLUSIONS
  GS after LSG is a rare complication but requires standardized management. Most cases can be treated successfully with endoscopic balloon dilatation.
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France.
authors.forename: Lionel
authors.initials: L
authors.lastname: Rebibo
authors.affiliation: Department of Gastroentrology, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France.
authors.forename: Sami
authors.initials: S
authors.lastname: Hakim
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France.
authors.forename: Abdennaceur
authors.initials: A
authors.lastname: Dhahri
authors.affiliation: Department of Radiology, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Yzet
authors.affiliation: Department of Gastroentrology, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Delcenserie
authors.affiliation: Department of Digestive Surgery, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.|Jules Verne University of Picardie, EA4294, F-80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.|Clinical Research Center, Amiens University Medical Center, Avenue René Laennec, F-80054, Amiens Cedex 01, France. regimbeau.jean-marc@chu-amiens.fr.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Regimbeau
mesh_terms: D000328:Adult; D002404:Catheterization / Q000379:methods / Q000706:statistics & numerical data; D003251:Constriction, Pathologic / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D016896:Treatment Outcome
keywords: Endoscopic dilatation; Gastric twist; Laparoscopic sleeve gastrectomy; Stenosis; Stent